Chinese Medicine and Explanations

by Martha Lucas, Ph.D., L.Ac., Chair Research Committee

Human beings want to know why or how things work.  We crave explanations.  Very often explanations hinge on what are we willing to accept as evidence that something happened.  You might think that the scientific method would offer a solution to this dilemma but it does not.  It is a common misunderstanding that science proves things when in fact it does not.  You can’t prove anything.  What scientific research does do is disprove things until you are left with what can’t be disproved. In other words, it eliminates all the competing hypotheses until there is one explanation left. That still doesn’t mean that it’s the “right answer”, it just means that you have found the best explanation that matches the facts at the moment.  The fictional detective Sherlock Holmes gives a compact and concise description of the scientific method: When you have eliminated everything that cannot be what remains, no matter how unlikely, is what must be. It’s not proof; it’s the last good explanation. Somewhere along the line we have lost track of that fact and people talk incessantly about “proof”.  I ask you, what is proof?  What would prove something?  Someday another ambitious research will find a way to disprove the current explanation and then we’ll have another one. That is how science progresses. If we want legitimacy, it will take good science.

There is no doubt that scientific explanation is preferable to other types of explanation when one can apply scientific methods to the topic of interest.  But again, I want to reiterate that the proper use of the scientific method allows us to find the “best” explanation of a behavior or outcome, not the truth or the only explanation.  And in fact, even when the most rigorous scientific methods are used there is still the possibility that the explanation or outcome is not valid.  The current backpedaling by pharmaceutical companies who are taking drugs off the market because their explanation of the safety and/or efficacy of the drug was flawed is an example of how the research outcome is always inadequate; always less than all the information.

The Chinese Medicine community needs to find a way to participate in the process of research.  We need to weed out the explanations that cannot be and see what’s left. That is the key to finding the best explanation for what works in Chinese Medicine. (Future articles will focus on how we can best do this.)  

We in the Chinese Medicine community often rely on belief-based explanations for how our medicine works, rarely resorting to a scientific approach.  For one thing, TCM school does not train us how to do research.  We cannot see Qi.  We can’t see the Lung channel or how the energy flows through the channel when we insert a needle.   And what does that actually mean?  How would you show someone?  That is a cardinal principle of the scientific method: a test that allows other researchers to see what you see.  With the current pressure to “fit in” to the medical community it is not enough to just tell someone that you “know” that the Qi is there.  We will continue to be relegated to the categories “alternative” or “complementary” or “unproven” medicine rather than to the simple category of “medicine” unless we can produce research.

This movement to put Chinese Medicine under the category CAM (Complementary and Alternative Medicine) seems to be accompanied by the feeling that we practitioners of Chinese Medicine should be pleased – no, not pleased, thrilled – to be a part of CAM.  Why should we?  We practice a bona fide, complete, well researched (albeit in Chinese), highly effective system of medicine.  Why the move to put Chinese Medicine into categories (i.e., alternative, complementary) unbefitting of its status as a complete system of medicine?  Because in the American annals of scientific research there is a dearth of studies that “prove” how Chinese medicine works.  Frankly, I consider this CAM movement barely one step ahead of putting us in the category of voodoo medicine.  If you compare the length of time that Chinese Medicine has been practiced with the much shorter history of Western medicine you would call Western medicine the alternative one.  In China, it probably IS the alternative!

In future articles one of the things I will be talking about is how we can use case studies to help move the research on Chinese Medicine forward.  Each of us has tons of data in our offices that, correctly collected and compiled, can lead to more “standardized” explanations of how Chinese Medicine works.