— updated 2006-03-15

Herbalist Review, Issue 2006-#1:
The problem of integrating Chinese herbology with allopathic and western medical traditions — a personal perspective

by Roger W. Wicke, Ph.D.

It is not always clear how to integrate knowledge from disparate health traditions. Without a firm foundation in the philosophies of each tradition, "integration" can be a recipe for confusion. On the other hand, integration without violating the internal logical consistencies of each tradition can often lead to great insight.

Subtopics on this page…

• Introduction
• A personal perspective: how I've chosen to integrate knowledge from various sources and why
• Guidelines for integrating Chinese herbology with other health care systems
• Phenomenological vs. causal reasoning
• Medical disease diagnosis vs. TCM assessment
• On the merits of Ayurveda vs. TCM
• Summary

 
Copyright ©2006 by RMH-Publications Trust; all rights reserved.

Introduction

An increasing number of American and European herbalists are recognizing the lack of a coherent assessment ("diagnosis") paradigm in typical western herbal practice. Consequently, some herbalists have developed their own idiosyncratic systems. It is evident from their writings that some of these herbalists have borrowed significantly from Chinese herbology and Ayurveda. It is also evident that a growing portion of western herbalists have become receptive to Chinese herbology as they recognize it has the potential to fill in a major gap in their own techniques — mainly in clinical assessment.

The ideas for this article arose from an extended debate among herbalists about how to effectively integrate herbal traditions from different cultures when the underlying philosophies and principles of these traditions may differ radically. One cannot simply mix together, simmer, and stir a bit, hoping that the resulting concoction will be either pleasing or useful. Without careful thought, the internal logical consistency of these traditions may be sacrificed for the appearance of eclectic wisdom, and the resulting bastardization of terminology may only confuse. Traditional Chinese herbology, Ayurveda, western herbology, and allopathic medicine are each characterized by sets of terminology and rules of logical deduction for which one-to-one correspondences are not easily described. For example, the traditional Chinese term "Deficiency of Yin" has no simple corresponding equivalent in western medicine. An accurate and concise description requires at least several paragraphs of explanation. Likewise, how does one apply recently discovered antimicrobial properties of various herbs that have been described in traditional texts long before bacteria, viruses, and other microbes were discovered?

As traditional Chinese herbology has become popularized worldwide, the dominant culture of scientific materialism applies political and economic coercion to "biomedicalize" and "scientize" it, to make it more amenable to profit-making schemes. Such schemes have been described in a previous article:

• Orwellian schemes for maximizing health-care industry profits — How these endanger the practice of herbal medicine

The desirability of integrating the best and most useful aspects of various herbal and health care traditions is admitted even by many mainstream medical practitioners. The limitations of western medicine are increasingly evident in dealing with chronic illnesses, antibiotic resistance, environmental toxicity, and disorders with significant mental-emotional-spiritual aspects. The crucial question is how to integrate disparate health care traditions and yet preserve the intellectual and practical insights that each may offer.

A personal perspective: how I've chosen to integrate knowledge from various sources and why

The debate on the relative merits of various systems and philosophies of health care have echoed throughout millenia of human history, with the forces of western medicine/herbology, TCM, Ayurveda, and homeopathy all jockeying for power, influence, and the claim of superior truth. I've come to believe that most people are blissfully unaffected by reason and that beneath all the rhetoric, we as humans tend to follow the biases in which we've been indoctrinated as children.

So to be fair, let me explain the origins of some of my own biases. Since childhood I've been programming computers for entertainment, to carry out professional projects, and for the last 10 years, as part of a long-term project to develop databases and expert systems software for TCM clinical assessment and problem solving. Like a lot of herbalists, I began exploring herbs because of personal health needs. But my computer-oriented biases have always been in the background. When I evaluate the merits of various systems of herbology, I'm somewhat less interested in the religious, philosophical, or esthetic merits than the following criteria:

1. Is it clinically effective?
2. If so, how much of the paradigm can be reconstructed with mathematical/logical algorithms and programmed into software?
3. How can this paradigm be taught to students so that they will be able to use it effectively and flexibly (in contrast to dogmatically) as a tool in their practices?

I'm not interested in promoting a pseudo-religious cult under the guise of science, or in maintaining the philosophical purity of any ethnic tradition merely for its own sake — there are plenty of others eager to fight over these issues. As such, I'm firmly entrenched in the traditional American pattern of borrowing ideas from other cultures when they are useful. It's very difficult to define a unique and independent American cuisine; our foods have originated from a polyglot of cultures - American Indian, Italian, French, German, African, Chinese, etc. Why must we as herbalists get into a snit over the ethnic origins of our herbal practices? Yet this issue keeps coming up in Internet discussion groups and conferences so much as to lead me to wonder at the hidden ethnic biases and insecurities that underly some of comments I've heard and read. Once, when I was presenting a short seminar on the principles of Chinese herbology at a conference of primarily western herbalists, one participant condescendingly dismissed my presentation with the reply "But those ideas aren't based in the European tradition." I was speechless. I become utterly discombobulated when someone responds to a reasoned argument, not with any logical rebuttal, but rather, with a declaration that the European tradition is presumed superior and requires no debate.

To program a computer, which is inherently free of ethnic biases and responds only to the rigid logic of 1's and 0's, to do something like medical diagnosis or TCM clinical assessment (I avoid calling it "diagnosis" for legal reasons), one requires a reasonably well defined set of rules that defines the assessment paradigm. Sorry, but while intuition is a fine thing, one cannot program a computer solely with intuition and, moreover, one cannot teach effectively. While I know of some western herbalists who, after years of study and experience, have developed their own effective methods, the lack of a coherent and systematic approach makes their insights difficult to communicate to the next generation. The Chinese were fortunate that their herbalist-scholars recorded the rules of their paradigm in detail, so that each future generation would not have to tediously rediscover these basic insights, and, instead, could continually refine them. The rules of TCM assessment are defined with a sufficient level of detail that the following computational criteria can be fulfilled:

1. 500 or so of the most common clinical symptoms and signs (e.g., fatigue, insomnia, abdominal distention, various fevers, various skin rashes, reddish tongue, yellow tongue coating) comprise the elements of a schema that defines about 140 distinct symptom-sign patterns. These 140 patterns, in turn, define a multidimensioned state-space of ill health that is relatively complete and without significant holes, or localized regions in which the space is undefined. (It helps that the patterns happen to be chosen to facilitate orthogonality and linearity, two criteria for construction of a well-behaved state-space.) For in-depth discussion of the concept of a multidimensioned state-space for describing the TCM pattern-recognition paradigm. see:
   • See Chapters 1-3 of Traditional Chinese Herbal Sciences, volume 1; In: HerbalThink-TCM software
2. The state-space described in #1 allows for one to devise a measurement criteria, just as with any orthogonal measurement system, that allows one to quantitatively measure the similarity or disparity between two clinical patterns.
3. Criterion #2 then allows us to create a corresponding state-space for herbal properties (a simplified example: heating/cooling, drying/moistening, etc.) that complements the state-space of patterns. Thus for the state-space pattern "Deficiency of Lung Yin", which is a dry-hot pattern affecting the lungs and throat, one would then go to the corresponding state-space for herbal properties and search for an herb or combination of herbs whose net effect would be to moisten-cool.
4. Because individual basic patterns are defined either in terms in individual dimensions or N-dimensioned manifolds, they can be combined to form an infinite variety of complex patterns that can match almost any clinical manifestion. (So, for example, one can have a client with a combination of Liver Qi Stagnation plus Liver Yang Rising and Deficiency of Spleen Qi - a pattern that might manifest as a case of simultaneous irritable moods, hypertension, migraine headaches, plus intestinal "dysbiosis" - and this complex pattern can be described mathematically in the defined state space and quantified numerically.

The reason that #2-4 above are important is that without these being implicit in one's paradigm, one cannot say to a student, "Your herbal formula is way off base for this client, it will result in either death or severe side effects." Or "Your herbal formula is close, but it might be even better with a bit of X thrown in." #2-4 are merely ways of wording the "intuitions" that western herbalists may have, or the conscious analyses that TCM herbalists conclude, in order to define the mathematics necessary for a computer to understand. (Although computers are free from ethnic biases, they require their instructions to be quite explicit so as not to become confused, much like beginning students of herbology.)

Interestingly, during the 1990's several MIT artificial intelligence researchers stated that expert systems for medical diagnosis had repeatedly encountered a seemingly insurmountable bottleneck: while individual medical disease entities have specific criteria for their diagnosis, the actual clinical reality is far more ambiguous, for there are many combinations of symptoms and clinical signs that fail to yield a clear diagnosis. •[a1]• Effectively, they were admitting that medical diagnosis, in spite of and even because of its complexity, fails to fulfil the equivalent of criteria #1 above — the state-space defined by conventional medical diagnosis is not only filled with holes, but with vast regions that are either not defined or poorly defined. Their conclusion was that a pre-processor stage would be required that parsed the data of clinical symptoms and signs into a more fundamental state-space of variables, which could in turn provide the framework for more accurate conventional medical diagnosis. It is my own conclusion that TCM theory already provides the basis for the "preprocessor" stage that the MIT researchers claim is necessary to improve the performance of expert systems in medical diagnostics.

When I first became interested in herbs 30 years ago, I had read several books by western herbalists, starting with John Christopher, and taking a number of classes. After flailing about for a while, I began reading several textbooks of Chinese herbology recommended by an acupuncturist friend. I was instantly impressed by the level of detail in the assessment system. I have never encountered anything in western herbology, Ayurveda, or any other herbal tradition, that even approaches this level of detail. Why reinvent the wheel if one already exists, with lubricated bearings and hub cabs even?

My own experiences with homeopathy are uncertain at best, it seems unpredictable, but I have not studied it with enough depth to adequately evaluate it. I do know from studying the homeopathic materia medica, that many remedies have listed so many symptoms that it seems difficult to make sense of the priorities; I would assume that this comes with experience. However, while detailed symptom-sign pattern matching is the fundamental similarity between TCM and homeopathy, when one attempts to construct a workable state-space from the thousands of remedy-based patterns, it becomes quite difficult. Perhaps some mathematician-homeopath might attempt it, but it would seem to me a gargantuan task. TCM, on the other hand, strikes a balance between detail and conceptual elegance that facilitates constructing mathematical schema, and thus might fulfil the role of the "pre-processor" stage that the MIT researchers predicted would be necessary for more accurate computer-aided medical diagnosis.

Finally, to dispel the notion that only "Chinese" herbs must be used within the TCM assessment paradigm: one can use any herb or food as long as one can describe it in terms of criterion #3. See the following article for a discussion of how this works, and how the western materia medica needs to be refined in order to fulfil this criteria:

• TCM paradigm and western herbs: Oregon Grape root as example

Guidelines for integrating Chinese herbology with other health care systems

First, we should ask what we wish to achieve by a synthesis of the Chinese herbal tradition with Western systems of medicine and herbology. Integration merely for the sake of integration, or as an intellectual exercise, or to appease the delicate cultural sensibilities of one's audience is usually a bad idea. It often leads to a mishmash of confused ideas, slippery definitions, and schizophrenia.

Personally, I favor a "take no prisoners" approach to intellectual synthesis. If two different systems reputedly deal with the same problem space (in our case, health and disease), I'll try to figure out which one does the best job and then simply not waste any more time on the inferior system, with the following exception: if there are ideas or insights in the inferior system that are not replicated in the other, I'll try to integrate these, and only these, into the better system. Discard the rest. I only have so much time. Let the cultural anthropologists write esoteric papers on the detritus; these folks do serve a valuable function as archivists of ancient knowledge. If I've made an error in my synthesis, then perhaps people in future generations can study the archives of the cultural anthropologists, then reassess my conclusions and attempt to patch them up.

Here's a short checklist of the results of my own synthesis, which has evolved from a combination of trial and error, much reading, and clinical results, the final and ultimate test:

• Of all the various herbal traditions I've studied, I've spent by far the most time on TCM because it has the best assessment techniques to offer the low-tech herbalist. If one cannot do expensive tests, then one has to rely on one's basics senses and the symptom perceptions of the client. For example, all one's knowledge of hormone physiology becomes a theoretical castle in the sky if one cannot measure the levels. One might speculate, but these speculations must then be based on the symptoms and observable signs and their known correlations with hormone physiology.
• The teaching methodologies of TCM are in the dark ages of rote memorization. Numerous educational psychology studies over decades have proven that certain methods work better - experiential learning to motivate and anchor knowledge in long-term memory, using case studies to motivate students to learn and memorize the most important information. In this aspect, many western herbal teachers are already doing a lot of things right: taste-testing the herbs in one's materia medica, keeping journals of one's subjective experiences, discussing case studies as a way to illustrate techniques and improve clinical skills. The brute force rote memorization techniques of traditional Chinese education I've simply discarded. They do not work for the average American student; only the very best survive this nonsense. One colleague who has taught at a TCM college informs me that 80% of TCM students feel unprepared to use herbs and eventually give up on them, primarily because the obsession with rote memorization has not prepared them with the practical skills necessary for analyzing and working through a clinical case. Instead of rote memorization, since 1998 we at RMHI have developed interactive computer game software to help students learn basic theory and data:
  • Computer-aided instruction in TCM clinical analysis and decision-making skills
• Since I'd estimate that 70-80% of all illnesses in America are due to diet and environmental factors, it is important to keep up with the latest discoveries in nutritional sciences and environmental health issues. The U.S. naturopathic profession and its allies are invaluable sources of this type of information. Traditional Chinese medicine has nothing to say about Aspartame, microwave ovens, margarine, cell phones, TVs, etc. - these did not exist until recent history. I find the traditional Chinese literature on diet to be largely irrelevant. It is a tedious distraction to search out momordica fruits to tonify one's Lung Yin, when the Deficiency of Lung Yin might be caused by the lack of a humidifier in a forced-air heating system or an improperly vented exhaust outlet. It is a waste of time to focus on eating exotic Chinese vegetables to remedy a Stomach Yin Deficiency when such a condition might be seriously aggravated or caused by sensitivites to various American foods, like soy, milk, alcohol, artificial additives, genetically modified foods, etc.
• Heavy metal toxicity is a widespread problem. TCM says almost nothing about this subject - I've asked many of my colleagues, so it's either well hidden or nonexistent knowledge. On the other hand, western physicians and naturopaths have made major breakthroughs in this area within the past decade, and I find these techniques to be indispensible in combination with TCM methods.
• The naturopathic and alternative health community has made many interesting and very likely effective improvements for dealing with cancer. I have six friends who have survived cancer, all more than 20 years, and by exclusively using "alternative" services of several Mexican cancer clinics. So although hype and disinformation on reputed cancer remedies may abound, some of the information coming from American and European clinics on how to deal with cancer is far ahead of anything I've read from China. Most TCM reports on this subject are rehashes of the standard approach of supplementing radiation and chemotherapy with tonic herbs and herbs to counteract the medical treatment side effects. While this may be useful, I do not consider it "cutting edge" knowledge, especially in light of recent studies documenting the ineffectiveness of most chemotherapy and radiation treatments for cancer. A few years ago, the director of an internationally known cancer research clinic enrolled in my course. I took the opportunity to question him on his opinion of the current state of the art in chemotherapy and radiation — his reply was that the vast majority of it was useless garbage (the possible exceptions being certain drugs for childhood leukemia), not only ineffective, but likely speeding up patients' demise. He was personally much more interested in the work of Gerson and several Mexican cancer doctors; he was especially interested in accessing the detailed Gerson archives and reevaluating them with his newly acquired knowlege of TCM.
• As China continues the race to pollute and despoil its vast land area, it becomes increasingly important to understand how to use locally grown herbs. Fortunately, the TCM materia medica includes some of the very same species that are used as herbs in America and Europe. This could give western herbalists a head start in figuring out how to use these herbs in a more precisely targeted manner. The whole ecology and permaculture movement in the U.S. is a more compatible fit with the sensibilities of most American natural health patrons, and it makes sense to integrate this into a comprehensive herbal tradition rather than to be dependent exclusively on imported herbs.
• Western herbalists tend to emphasize the botanical aspects of herbal practice more than most TCM herbalists, many of whom do not even know the botanical species name of the herbs they use. I require my students to learn the botanical names; most TCM schools do not. Adulteration and species substitutions are a significant problem among many Chinese herb wholesalers and distributors. My own supplier take these matters seriously, as well as testing imported lots for heavy metals and pesticide levels, but until recently this has been the exception rather than the rule for Chinese herb companies and distributors.
• TCM assessment methods have some potentially interesting applications, such as helping to understand the health effects of music and sound. There is a vast amount of research proving beyond any doubt that music has powerful and often rapid effects on measurable physiological parameters, both positive and negative: EEG patterns, hormone levels, heart rate, even the growth pattern of neurons and dendritic branching patterns in the brain. Yet most of this research fails to ask the question why a specific piece may send one individual into ecstasy, whereas the same piece might trigger a headache in another. However, the majority of this research indicates that of all the world's music, European classical music (Mozart, Haydn, Bach, Beethoven) has by far the most generally beneficial effects. (I've never been much impressed by traditional Chinese music.) So in the realm of music therapy, I've used ideas from TCM assessment theory to evaluate and predict each individual's unique response to a piece of music, but I've chosen to focus on the classical European repertoire.
• The phytochemical and pharmacological data coming out within the past 20 years or so on herbs, including Chinese herbs, is useful supplementary information. It will never replace the traditional information, as any medical practice is always based on the symptoms and observable clinical signs at the first level of analysis, and I feel that TCM does this first level best. However, western scientific knowledge of herbal pharmacology and toxicology has definitely added a useful layer of understanding. As a consequence of this information, I have shifted toward a more conservative use of certain herbs to avoid long-term toxicity effects.

A number of herbalists have commented on the problems of studying ancient masters whose writings seem only barely relevant to current human conditions. For example, microwave ovens, synthetic sweeteners, genetically modified foods, and margarine did not exist until the late 20th century; we cannot expect much wisdom from the ancient masters in addressing problems in modern nutrition and environmental toxicity. However, what I like about the TCM assessment system is that it provides an accurate, computer-reproducible, rule-based system for describing and analyzing patterns of symptoms — these basic patterns of the body's reponses are almost universal in scope. They can be used just as readily to describe the effects of radiation damage, purified hormones, and many chemical pollutants, even though these did not exist before the 20th century.

Phenomenological vs. causal reasoning

TCM is a concise and detailed phenomenological system of correspondences, not an exposition of "causes" in the western sense of scientific materialism; its primary objective is to match up descriptions of whole-body patterns of easily recognized symptoms and clinical signs (tongue, pulse, body appearance) with herbs and herbal formulas historically observed to be effective for specific whole-body patterns. That is also perhaps why it has endured so long. (After all, how often do textbooks of science become outdated because their explanations of scientific causes becomes disproven or replaced by causal explanations of greater complexity?) Although limited in scope, what it set out to do, it does well. In a way, it is much like statistics, describing the correlations among symptoms and clusters of symptoms and how these clusters or patterns are likely to evolve and transform into other patterns.

While I am aware that Chinese texts talk about "causes", these are usually not causes in the western scientific sense of materialistic causation. That is not necessarily a disadvantage, and as I discuss in my textbooks, it is often a distraction to interpose a theorized physical basis for causation when the real goal in clinical practice is to match an effective herbal formula with the totality of the symptom-sign pattern so as to relieve it, whatever the "cause" or "causes". The primary flaw of western medicine is that is has become so obsessed with materialistic chains of causality that it often ignores the systemic whole-body patterns that are screaming for attention. Rather than "causes", I prefer to think in terms of "contributing factors".

In the textbooks I've written, I've taken pains to explain why the fundamental basis for TCM is not a causal one. A good majority of the terms used in TCM are functional rather than materialistic in nature. For example, "Qi" causes a lot of confusion. I find it amusing when some scientist speculates on what Qi might look like under the microscope or how it could be detected. Qi is not a physical substance; even the word "energy" is a crude and misleading translation. Traditionally and in a clinical sense, Qi is said to promote harmonious transformation within the body, to provide for retention of the body's organs and substances, and to warm the body. It is defined most accurately by the consequences of its absence or deficiency: fatigue, pallor, weak and quiet voice, soft-weak pulse, pale-tender tongue, and possibly organ prolapse, spontaneous perspiration, proneness to bruising and bleeding disorders. What is Qi physically? One can speculate as to all the physiological phenomena that might result in this pattern, such as insufficient thyroid hormone. But thyroid hormone is not Qi, nor are nerve action potentials, nor anything else, though these things might be correlated with Qi to varying degrees. Qi is a phenomenon, not a material substance that participates in a chain of causality in the western scientific sense. It is a practical term that summarizes functions that can be recognized by manifested symptoms, without intervention of technological measurement devices.

Medical disease diagnosis vs. TCM assessment

It is crucial to separate the idea of western medical disease diagnosis from TCM pattern assessment, and avoid debating the choices of herbal formulas for western diseases unless the TCM patterns are also considered.

I advocate that new students new to TCM, especially medical doctors and nurses, temporarily set aside their medical way of thinking while learning TCM theory and assessment. I assure them than after they have learned the patterns thoroughly, they will find that their medical knowledge regains its usefulness as a way to fine-tune the basic TCM assessment in given case, but to prematurely attempt integrating would only lead to confusion.

Most medical diagnostic terms have no one-to-one correspondences in the traditional Chinese theory of health and illness, and within the traditional Chinese paradigm, it is the medical diagnostic terms that suffer from excessive vagueness. For example "AIDS", "fibromyalgia", "autoimmune disorders", "hepatitis" are not precisely targeted diagnostic terms; one cannot design an herbal formula "for AIDS", "for autoimmune disorders", or for most other medically defined conditions without knowing the specific symptom-sign pattern or patterns involved in a specific case. The basic patterns in TCM are quite adequate for describing these problems in sufficient detail to point one toward appropriate herbal formulas and dietary regimes, with a few exceptions, such as autoimmune conditions associated with heavy metal toxicity. I've seen all these conditions in my own practice. I know quite a few people who were diagnosed with AIDS and/or were HIV+ and have survived more than 20 years without doing any toxic drugs, only diet and lifestyle changes plus herbal formulas occasionally. The cases of AIDS I've seen were all over the map as far as TCM patterns and formulas that were given. In my opinion there is no such thing as a single herbal formula appropriate "for AIDS". This is western medical thinking and simply does not work that well.

A lot of interest has arisen regarding epidemic illnesses such as hemorrhagic fevers. Here again, it is crucial to match the herbal formula to the pattern of presenting symptoms. The identity of the microbe is a minor consideration. The ancient Chinese devised successful herbal formulas for epidemic illnesses long before the science of microbiology came onto the scene. There are numerous herbs with broad-spectrum antibacterial and antiviral activity; much more important to consider are matching the herbal formula to the stage of the fever, degree of thirst and dehydration, presence or absence of delirium, rashes, hemorrhaging, excessive perspiration, etc.

Though hemorrhagic fevers are generally rare, I suspect we will be seeing more of these, and we may not have to wait long if the H5N1 virus in SE Asia becomes a worldwide pandemic. I've been involved as a consultant in several cases of hemorrhagic fevers for which the doctors in the hospital had essentially pronounced that they had tried everything in their arsenal, the patient would soon be dead, and they gave their blessing to try herbs as a last resort. All recovered. One individual went from having a 105 deg.F. fever with early-stage acute renal failure to an almost normal temperature with regained kidney function within 6 hours of drinking a large dose of herbal tea, and was discharged from hospital as they needed the beds for other similar cases. In all these cases the herbal formulas were only slightly modified from the standard TCM formulas for Ying- and Xue-stage Virulent Heat (Wen Bing) patterns.

The traditional Chinese literature (the Shang Han Lun and Wen Bing) nicely complements modern microbiological understanding of infectious illness, but to debate over causes can become a war of words. Pasteur himself stated before his death that he regretted that medical doctors and researchers had become so obsessed with microbial causes, as he realized that infectious illnesses resulted from a complex interaction among various factors, including the condition of the individual, the microbial flora, and environment.

For more discussion of how traditional Chinese theory of feverish illnesses (Wen Bing) is applied practically, see:

• SARS and TCM theories of epidemic illness

On the merits of Ayurveda vs. TCM

Although Ayurveda has useful insights to offer, its system of assessment if far less sophisticated; this becomes evident when comparing textbooks on TCM assessment (with typically around 120-140 distinct patterns defined and discussed) with those of Ayurveda. All the Ayurvedic courses and texts I have read focus on the theory of the three doshas (Vatta, Pita, Kapha), but don't go much beyond this level. TCM should acknowledge its debt to Ayurveda, as historically, Ayurveda was transmitted along with Buddhism via Tibet and then into China. Greco-Roman medicine during the time of Hippocrates and later had a similar four-element humoral theory of illness. Some historians believe that all these theories had their historical origins in India around the 500 B.C. period or earlier.

There are several aspects of Ayurveda that I have included in my course material, which I believe have been somewhat obscured and watered down in TCM. The first is the theory of the seven tastes and their inherent actions: thermal nature (hot/cold), humidity (dry/moist), and density (light/heavy). Also the idea that each taste may have differing predigestive, digestive, and postdigestive effects is consistent with the observation that various ingested substances, as they become digested and metabolized, will affect tissues they contact differently. The second is in the realm of diet. I once took a short course in Ayurvedic cooking; I've never tasted such delicious food that also felt healthy afterward. I've used this information in simple diet and cooking classes for clients. A lot of people have the idea that nutritious food will taste bad, bland, or uninspiring. Ayurvedic cooking proves this idea wrong, and I use the properties of the basic tastes to explain how to put together a meal that is balanced for a given individual and that also tastes good. While TCM doctors give lip service to the idea of good diet, Ayurvedic doctors place much greater emphasis on diet, and this aspect is certainly important in dealing with American clients whose diets are typically disastrous.

Summary

The optimal synthesis of traditional Chinese herbology with western medicine and science entails using traditional Chinese methods for describing whole-body patterns of symptoms and clinical signs and to incorporate knowledge from modern nutrition, biochemistry, pharmacology, microbiology, and pathology as means of fine-tuning the choice of herbs, formulas, dietary recommendations, and other therapies. The converse of this approach, which is to discard the Chinese model of pattern analysis and to choose clinical strategies based on medical disease criteria, is a method which is crude, simplistic, and ignores thousands of years of traditional Chinese medical wisdom. (Yet this is effectively what happens when one asks the question "What herbal formula is good for disease X?" and ignores all other considerations.)

As traditional Chinese herbology is a descriptive, phenomenological system, its insights remain valid regardless of advances in scientific materialism (materialistic causality). The two systems operate on distinctly different planes of thought and reasoning, and, consequently, they are mutually complementary.

To read more on the philosophical differences between western scientific medicine and traditional Chinese herbology, see:

• See Chapters 1-5 of Traditional Chinese Herbal Sciences, volume 1; In: HerbalThink-TCM software

References

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• [a1] Szolovits, P., Patil, R., and Schwartz, W.; "Artificial Intelligence in Medical Diagnosis" In: Annals of Internal Medicine Vol.108; No.1, pp.80-87 (1988 January). (Also in webpage at: —{{  http://medg.lcs.mit.edu/ftp/psz/SchwartzAnnals.html  }} )