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Taking the pulse of modern TCM (3)

(Shanghai Daily)

09:12, March 12, 2013

Within seconds the robot captured basic physical information and compared it with its database of different pulse types, breathing, tongue conditions and complexions. The machine swiftly delivered a preliminary diagnosis. The system could potentially help patients far away, if the right photo, recording and communications equipment were available.

"Frankly, to modernize TCM or not is always a controversial issue, even today," says Dr Shang Li, director of the Shanghai Association of TCM International Exchange Center, a government-backed organization that promotes the TCM industry to the West.

"Western medicine and TCM are two entirely different systems. TCM was formed by millions of cases and the prescriptions were invented through doctors' rich clinical experiences," he says.

But Dr Shang is still positive about scientific development in TCM, which, he says, might be a great aid in promoting its understanding and acceptance in the West.

"I have to say, TCM doctors and the Western medicine practitioners are like people living in two different worlds; quarrels never end," Shang says with honor. "Western medicine is built upon accurate statistics, rigorous logic and scientific proof, while TCM is kind of abstract and random, even mysterious."

For many years, lack of unified standards, accurate dosage and scientific studies were cited by Chinese and Western critics of TCM.

"That's because traditional Chinese medicine holds that each patient is unique, thus, they should be treated in different ways with 'customized' approaches," Shang says.

Ancient TCM texts describe dozens of pulse types, tongue colors and complexions, facial aspects, which are important in making a correct diagnosis.

The old descriptions can be difficult to grasp, however, and only practice with an experienced doctor enabled practitioners to understand in the old days, and even today.

Descriptions of pulse in one text are an example cited by Dr Zhang. "A string pulse is just like a tight, tense string, which might indicate something wrong with liver and gallbladder; a smooth pulse is like pearls falling to the ground, which might be a signal of anemia and rheumatism."

"Can you figure out exactly what kind of pulse is like a tight string or falling pearls It's too abstract and vague. You'll never know until you feel the different pulses for hundreds and even thousands of times," Shang says. "It's the same facial complexion. What's a pale face? What's a yellow or red face? The correct diagnosis is based on a doctor's rich clinical experience."

As an intern, Shang followed his own teacher in a TCM hospital and found that each master doctor had his own unique treatments and prescriptions.

"With just a quick glance at a patience, they would tell me to add or reduce 15g of some herbal medicine," he recalls. "It was not something learned from textbooks, it came from extensive clinical experience and experiments. That's why many people find TCM unsystematic and lacking unified standards."

The TCM diagnostic equipment was tested around a year and a half ago and got mixed, lukewarm reviews.

"The machine's pulse reading was not very accurate because the results were quite different from what we doctors did, but the tongue diagnosis the robot made was not bad," says Professor Zhou Duan from Shanghai TCM University and former deputy director of Longhua TCM Hospital.

Zhou has practiced TCM for more than three decades and says that TCM modernization and standardization should be more focused on pharmacology, herbal treatment, quality control, extraction techniques and storage.


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