Traditional Chinese Medicine: China's Unique Resource Treasury

Interviewer: Did you have any exposure to Traditional Chinese Medicine (TCM) in your early years? How did you and those around you perceive TCM at that time?

Jia Weiping: I've always had a fondness for TCM. When I entered university in 1975, our education system encouraged students and teachers to learn outside the classroom. We would visit factories, rural areas, military units, and shops as part of our "grand classroom" experience. During this time, I went to a grassroots hospital, similar to today's township health centers, which led to my enduring connection with TCM.

At the grassroots hospital, I spent about half a year memorizing herbal formulas and prescriptions under the guidance of an elderly TCM practitioner. He taught me many easy-to-remember rhymes, which sparked my interest in TCM. I came to appreciate the miraculous nature of Chinese herbs and their significant role in treating diseases and safeguarding the Chinese people for thousands of years.

As a researcher and clinician specializing in diabetes, I've also gained some understanding of TCM's approach to diabetes treatment. TCM's records of diabetes can be traced back to at least before the Common Era. The "Yellow Emperor's Inner Canon" contains descriptions similar to what we now know as Type 2 diabetes. The "Plain Questions" chapter states: "The Emperor asked: 'What is the name of the disease that causes a sweet taste in the mouth? How does one contract it?' Qi Bo replied: 'This is an overflow of the five qi, called spleen-wasting. When the five flavors enter the mouth, they are stored in the stomach. The spleen circulates their essence and qi. As the body fluids are in the spleen, it causes a sweet taste in the mouth. This is caused by rich and sweet foods. Such people must frequently eat sweet and fatty foods. Fatness causes internal heat, and sweetness causes fullness in the center, so the qi overflows upward and turns into wasting-thirst.'"

Here, "spleen-wasting" is similar to what we in Western medicine call Type 2 diabetes. This shows that even in ancient times, people were aware of the phenomenon of diabetes.

Interviewer: As a Western medicine academician, you also have a great affinity for TCM and have engaged in cross-disciplinary collaborations in clinical work and research. There are persistent doubts in society about TCM, with claims that its effectiveness lacks high-level evidence support and that it is "pseudoscience." From a Western medical perspective, where do you see TCM's comparative advantages? What are the root causes of these recurring criticisms?

Jia Weiping: TCM is a profound and ancient system with a long history. It is a classical empirical medical system constructed by the Chinese people through practice and remains the most complete traditional medical system in the world. In 2015, Professor Tu Youyou from the China Academy of Chinese Medical Sciences won the Nobel Prize in Physiology or Medicine, the highest award in the medical field received by a Chinese scientist to date. This fully demonstrates the international scientific community's high recognition of Chinese traditional medicine and China's growing research capabilities. We should tap into this unique resource treasury of TCM and stand confidently on the world medical stage.

In my view, TCM's advantages are manifested in three aspects: First, TCM has accumulated rich knowledge about the human body, diseases, and medicines over thousands of years of development, making it a unique health resource. TCM is a treasure of ancient Chinese science and a key to unlocking the vault of Chinese civilization. Through the analysis of natural medicines and the in-depth exploration and transformation of classical and empirical formulas, we may produce a large number of new drugs for clinical application, benefiting patients. Second, TCM uses holistic concepts and systemic thinking to guide practice, emphasizing that the human body is an organic whole, stressing the unity of humans with the natural environment and social environment. These concepts are still very advanced even by today's standards and have great guiding significance for the diagnosis and treatment of diseases. Third, TCM's concept of "treating before illness" covers the entire process of health and disease, which aligns with our current emphasis on "shifting from a disease-centered to a people's health-centered approach." Moreover, in addition to treating diseases, TCM has a rich array of methods for health maintenance, such as medicinal baths, medicinal cuisine, moxibustion, cupping, Tai Chi, and Baduanjin exercises. In short, TCM has great potential in managing human health throughout the life cycle.

The degree of acceptance of TCM still lags behind that of Western medicine, primarily because its mechanisms of action and efficacy have not been elucidated by modern science, which also limits its understanding and acceptance by international colleagues and the public. We need to further strengthen the evidence-based medicine capacity of TCM, establish an evidence system that aligns with TCM characteristics, and explain TCM's mechanisms of action in "modern universal language" to highlight its advantages in disease treatment.

Creating a New Medical System Integrating Chinese and Western Medicine

Interviewer: During his inspection tour in Nanyang, General Secretary Xi Jinping emphasized the need to uphold tradition while innovating, actively promote TCM research and innovation, focus on interpreting TCM principles using modern science, promote the combination and mutual promotion of traditional Chinese medicine and modern science, and promote the mutual complementation and coordinated development of Chinese and Western medicine to provide better health services for the people. You also emphasized that the revision of the guidelines is based on high-quality evidence. Do you have any suggestions for TCM research and innovation? How do you think we can achieve the interpretation of TCM principles using modern science?

Jia Weiping: Many TCM theories originate from ancient Chinese philosophy, leading to misunderstandings of TCM as "superstitious," "illusory," or "pseudoscience." To eliminate these misconceptions, we must interpret TCM principles using modern scientific methods. This includes two aspects: first, demonstrating the clinical efficacy of TCM using globally recognized methods and scientific research evidence; second, explaining the mechanisms of TCM using modern scientific language.

To interpret TCM principles using modern science, we must first boldly adopt modern scientific technologies at the technical level. For instance, in the context of multidisciplinary integration, technologies from medicinal chemistry, virology, immunology, pharmacology, information science, and other disciplines are widely applied in researching TCM mechanisms, accelerating the modern understanding of TCM's scientific connotations.

Secondly, we need to strengthen the development of interdisciplinary TCM fields and talent cultivation. We should enhance the intersection of TCM with natural sciences, modern technology, information technology, artificial intelligence, big data, and other disciplines, fully utilizing modern scientific technologies to expand TCM's innovative development. We also need to cultivate academic leaders with interdisciplinary backgrounds in various fields to form forward-looking and original academic thought systems.

Lastly, we need to create a favorable external environment by reforming and improving the organization, acceptance, and evaluation systems for TCM and related scientific research. Simultaneously, we should perfect long-term stable support mechanisms for universities, research institutions, and researchers, creating an environment that encourages innovation and is prudently inclusive.

Interviewer: Some argue that the mutual reference and trust between Chinese and Western medicine, and their integration, will construct a perfect medical model for humanity. What is your ideal perfect medical model? What roles do Chinese and Western medicine play in this model?

Jia Weiping: TCM is a clinical practice medical system formed and accumulated by the Chinese nation over thousands of years of fighting diseases, while Western medicine is a modern medical scientific theoretical system based primarily on anatomical and experimental research. Both TCM and Western medicine are important components of world medicine, complementing each other to serve human health, survival, reproduction, and development. These two medical systems are not superior or inferior to each other, nor are they mutually exclusive or negating. Instead, they are mutually compatible, complementary, and mutually fulfilling, jointly benefiting humanity. However, both TCM and Western medicine have their own shortcomings. This requires us to integrate the advantages of both to provide the best diagnostic and treatment options for the people. Therefore, in my view, the integration and equal emphasis on Chinese and Western medicine is the inevitable direction and necessary path for future medical development. The two medical systems should exchange ideas, learn from each other's strengths, complement each other's advantages, and develop together to better contribute to a healthy China and create a new medical system that integrates Chinese and Western medicine.

Interviewer: Do you have any other suggestions for the future development of TCM?

Jia Weiping: I believe that drug research and development transformation is a crucial aspect. This is an effective way to break through the "dimensional wall" between Chinese and Western medicine and strengthen mutual learning and reference. For example, for Western medicine practitioners, it's easy to understand using American ginseng to treat fatigue, but when it comes to specific dosages and combinations of herbal pieces, it might be relatively difficult. Developing Chinese medicines and formulas into proprietary Chinese medicines, supported by high-quality research evidence for safety and efficacy, and including them in expert consensuses or medical guidelines, can guide clinical medication for Western medicine practitioners. This aligns with the knowledge system of Western medicine, allowing them to quickly master the usage and dosage and prescribe it to patients.

The second point is to strengthen the interpretation of TCM efficacy using "modern universal language" and enhance evidence-based medicine support. Only by continuously increasing the number of TCM clinical studies, raising the proportion of high-quality, large-sample, multi-center studies, and constantly improving evidence-based TCM research methods and technical specifications can TCM treatment methods supported by high-quality clinical evidence be better applied to clinical decision-making, allowing their clinical efficacy to be better realized.