The following is a continuation of a discussion on the Unified Medicine Project, which has been created by the American Chinese Medicine Association with the goal of helping to establish the future of medicine.
Medicine vs. Patents
Patents, as grants of property rights to the inventor, are restricted to individual inventions. Each invention is an independent entity, and each patent an independent protection for the corresponding entity of invention. Therefore, there is no accumulative protection mechanism with regard to inventions by means of the patent system.
Due to the lack of accumulative protection mechanisms, subsequent inventions with substantive modifications and alterations to a pre-existing patent might be justified to apply for a new patent with a different name. This situation originates from the fact that patents are not in a scientific field, and therefore do not have the accumulative nature a scientific field has. As a result, new modifications and alterations might lead to changes in a patent name. If growths and developments based on a pre-existing patent are significant enough, they can be regarded as modifications and alterations to the previous patents.
It should be pointed out that even in the case of patents, rigorous scrutiny is required to determine whether the modifications and alterations are significant enough to justify applying for a new patent name. Without the rigorous scrutiny, it's inappropriate and invalid to claim a new patent name based simply on the modifications and alterations of previous patents.
Medicine, however, is very different from patents. Medicine is a rigorous scientific field. It's not an independent entity of invention. As a scientific field, there are accumulative characteristics in its growth and development. Further growth and development in one medicine, might lead to branches that derive from the pre-existing medicine. However, branches are branches; they cannot be named new medicines.
Therefore, any new growths, developments, modifications and alterations in medicine will be accumulatively added to the previous knowledge, and should be classified under the same name of the pre-existing medicine. They simply are branches of the pre-existing medicine. It's not justified to name a "new" medicine from the branches of a pre-existing medicine.
This conclusion holds true not only to medicine, but to any scientific fields that have accumulative characteristics such as mathematics, physics, chemistry, etc. There are many branches of mathematics, physics, chemistry, etc. based on growth and developments in these fields. However, none of the branches has been named as a new scientific field to replace the original, pre-existing scientific fields.
Parallel Developments
We acknowledge that there exists the possibility of parallel developments of human civilizations. For example, in the history of the Nobel Prize, some inventions were conducted independently at about the same time in history. After rigorous scrutiny of those parallel inventions, both inventors were awarded the Nobel Prize. This situation also might exist in historical developments of medicine and other scientific fields.
Similar to parallel inventions, any claims of parallel findings in medicine demand rigorous scrutiny before being justified in order to protect the integrity of science and medicine. However, this has not been rigorously carried out in the history of medicine. Letting parallel invention claims go unchecked will destroy the integrity of science and medicine.
Evaluation of Medicines
As discussed previously, due to historic reasons, the term "medicine" has widely been used without rigorous scrutiny. As a result, many "new" medicines were created in history, and many medicines now exist. One goal of the Unified Medicine Project is to give these medicines rigorous scrutiny hundreds or thousands of years after they were named, coined or established. In the following paragraphs, we will evaluate major medicines. Conclusions will apply to other minor medicines.
Chinese medicine (CM), also called traditional Chinese medicine (TCM), Oriental medicine, Asian medicine and Eastern medicine, is the world's first complete, systematic, independent and comprehensive medicinal system. Its origins have been dated back more than 600,000 years.
Chinese medicine is composed of many medical areas, such as Chinese herbal medicine (CHM), acupuncture, moxibustion, cupping, tui na, an mo, zheng gu therapy, acupressure, gua sha, qi gong, tai ji, psychotherapy, dao yin, preventive medicine, rehabilitation therapy, sports medicine, physical therapy, eugenics, dietary therapy, medicated food therapy, etc. Chinese medicine covers entire medical fields, from disease diagnosis and treatment to prevention and rehabilitation. It has been practiced in more than 100 countries around the world, and is one of the most influential medicines in human history. Since there are many books and sources about Chinese medicine, we will not elaborate on it here.
Western/allopathic medicine is a relatively new medicine compared to Chinese medicine. It's a systematic, comprehensive and independent medicinal system, and is the conventional medicine in many countries. Western/allopathic medicine also covers most medical fields, from disease diagnosis and treatment to prevention and rehabilitation. Together with Chinese medicine, it's one of the most influential medicines in the world. Since there are many books and sources about Western/allopathic medicine, we will not elaborate on it here.
Combination medicine (zhong xi yi jie he) is a unique medicine developed in China since the 1950s. It combines both Chinese medicine and Western medicine in regard to diagnosis and treatment in the practice of medicine, and covers entire medical areas. The goal of combination medicine is to achieve better therapeutic results than either medicine.
In evaluating combination medicine, people find that on the one hand, it has achieved many good results; on the other hand, it also has brought about many undesired outcomes. The advantages vs. disadvantages of combination medicine are the subject of much controversy and will be judged by time and history.
Oriental medicine was a synonym for Chinese medicine. It first was coined in the U.S. in the 1970s as a way of renaming Chinese medicine. It's an inappropriate synonym for Chinese medicine. It has caused much confusion among patients and the public, and has harmed the growth of Chinese medicine.2
Similar to Oriental medicine are Asian medicine and Eastern medicine. Both are inappropriate synonyms for Chinese medicine.2
Alternative medicine refers to all unconventional medicines used in place of Western/allopathic medicine in the prevention and treatment of diseases and illnesses in Western nations. "Alternative" is a relative term. For example, in China, as Chinese medicine has been the mainstream medicine for thousands of years, "alternative medicine" might refer to Western medicine, which has been in existence for little more than a hundred years. Therefore, the word "alternative" depends on which medicine is taken as the reference system. It's vague, inaccurate and indefinite, and cannot be used to describe independent professional medicines.
Complementary medicine refers to the unconventional medicines used as supplements to conventional Western/allopathic medicine rather than as replacements for Western/allopathic medicine. The word "complementary" also is a relative term and might cause confusion. For example, from the Western medicine viewpoint, other alternative medicines are regarded as complements to Western medicine. However, from a developmental time sequence, Chinese medicine was established earlier than Western medicine. So, from a historical viewpoint, the later-developed Western medicine would complement Chinese medicine. Therefore, the term "complementary" has no definite meaning either. It also depends on which medicine is taken as the point of reference.
In sum, the combined term complementary and alternative medicine (CAM) is vague, inaccurate and indefinite, and fails to describe independent professional medicines.
Integrative medicine is a term developed from complementary medicine. If a complementary medicine is accepted by Western medicine, it will be integrated within Western medicine.
As discussed above, because "complementary medicine" is a relative term and depends on which medicine is taken as the reference point, the term "integrative medicine" will have the same problem; therefore, the term "integrative" also is relative and indefinite. As a result, integrative medicine also is a vague, inaccurate and indefinite term, and cannot be used to describe independent professional medicines.
Chiropractic is a system of healing that treats diseases by manipulating the spinal column, body structures, etc. There are, however, questions surrounding chiropractic among many health care professionals:
- The contents of chiropractic are very similar to several branches of Chinese medicine such as tui na, an mo, massage, zheng gu therapy, etc. What is the content relationship between chiropractic and those branches of Chinese medicine?
- Chiropractic was founded in the 1890s.3,4,9 Chinese medicine was introduced to and practiced in Europe and many other countries more than 2,000 years ago. Therefore, chiropractic was established in an environment where Chinese medicine had been practiced for more than 2,000 years. What was the influence of Chinese medicine on the formation and establishment of chiropractic? What is the historical relationship between chiropractic and those branches of Chinese medicine?
- As discussed above, if a field is to be qualified as an independent professional medicine, it should be equipped with established, comprehensive, independent, distinguished, consistent, complete and systematic principles, theories, diagnostic techniques, treatment methods, etc. that are significantly different from other independent professional medicines. Does chiropractic have principles, theories, diagnostic techniques and treatment methods significantly different from Chinese medicine?
Further study and research are needed to clarify the above questions.
Naturopathy is a system of treatment of disease emphasizing assistance to nature by using natural medicinal substances. There also are questions surrounding naturopathy:
- The contents of naturopathy are similar to several branches of Chinese medicine such as dietary therapy, medicated food therapy, exercise medicine, psychotherapy, preventive medicine, rehabilitation therapy and Chinese herbal medicine (CHM). The question is: What is the content relationship between naturopathy and Chinese medicine?
- Naturopathy was founded during the 19th century.4,5,9 Chinese medicine was introduced to and practiced in Europe and many other countries more than 2,000 years ago, which means that naturopathy was established in an environment where Chinese medicine had been practiced for more than 2,000 years. What was the influence of Chinese medicine on the formation and establishment of naturopathy? What is the historical relationship between naturopathy and Chinese medicine?
- Naturopathy uses Chinese herbs directly. (Some of the herbs are used in English names rather than in Chinese pin yin names). Naturopathy also uses local herbs. As mentioned above, using local herbs does not justify being a new, independent professional medicine. What is the medicinal relationship between naturopathy and Chinese medicine?
- As discussed above, if a field is to be qualified as an independent professional medicine, it should be equipped with established, comprehensive, independent, distinguished, consistent, complete and systematic principles, theories, diagnostic techniques and treatment methods that are significantly different from other independent professional medicines. Does naturopathy have its own established, comprehensive principles, theories, diagnostic techniques and treatment methods significantly different from Chinese medicine?
Further study and research are needed to clarify the above questions.
Homeopathy is a system of medical practice that treats a disease based on the principle of "like cures like." There are many questions surrounding homeopathy:
- The basic "vital force"concept in homeopathy is similar to the concept of qi in Chinese medicine. The basic "like cures like" principle of homeopathy is similar to several treatment principles of Chinese medicine such as cong zhi, fan zhi, re yin re yong, han yin han yong, sai yin sai yong, tong yin tong yong, etc. The "like cures like" principle also exists in Chinese medicine's formulation principle - the application of zuo herbs. Therefore, there are very close similarities between homeopathy and Chinese medicine. What is the content relationship between homeopathy and Chinese medicine?
- Homeopathy was founded in the 1700s.4,6,9 Chinese medicine was introduced to and practiced in Europe and many other countries more than 2,000 years ago. Therefore, homeopathy was established in an environment where Chinese medicine had been practiced for more than 2,000 years. What was the influence of Chinese medicine on the formation and establishment of homeopathy? What is the historical relationship between homeopathy and Chinese medicine?
- Homeopathy also uses local herbs. As mentioned above, using local herbs does not justify the creation of an independent professional medicine. What is the medicinal relationship between Homeopathy and Chinese medicine?
- As discussed above, if a field is to be qualified as an independent professional medicine, it should be equipped with established, comprehensive, independent, distinguished, consistent, complete, and systematic principles, theories, diagnostic techniques, treatment methods, etc. that are of significant difference from other independent professional medicines. Does homeopathy have its own established and systematic principles, theories, diagnostic techniques and treatment methods significantly different from Chinese medicine?
Further research and study are needed to answer these questions.
Tibetan medicine is a system of healing practiced in Tibet. The questions surrounding Tibetan medicine are as follows:
- It's generally believed that the Si Bu Yi Dian laid down the foundation of Tibetan medicine. The Si Bu Yi Dian originally was written around the 8th century, but it was not published at that time. It was buried for more than 200 years, then edited, deleted, added, annotated, revised and first published around the 10th century.7,8 In 641 AD, about 100 years before the original writing of the Si Bu Yi Dian, Un-shing Kong-jo was married to Srong-btshan sGam-po. Un-shing Kong-jo brought many Chinese medicine books with her from China to Tibet. Those books were then translated into the Tibetan language and edited into the Yi Xue Da Dian (Medical Canon). The Yi Xue Da Dian was regarded as the earliest medical book in Tibet. What is the influence of the Yi Xue Da Dian on the formation and writing of the Si Bu Yi Dian?
- In 710 AD, dozens of years before the initial writing of the Si Bu Yi Dian, Gyim-shang Kong-jo was married to Khri-lde gTsug-btsan. Similar to Un-shing Kong-jo, Gyim-shang Kong-jo brought many Chinese medicine books with her from China to Tibet. Those books were translated and edited into the Yue Wang Yao Zhen. Since this book also was written before the Si Bu Yi Dian, the question is: What is the influence of the Yue Wang Yao Zhen on the formation and writing of the Si Bu Yi Dian?
- Tibetan medicine uses Chinese herbs directly. It also uses local herbs. As mentioned above, using local herbs does not justify the creation of an independent professional medicine. What is the medicinal relationship between Tibetan medicine and Chinese medicine?
- Tibetan medicine employs many Chinese medicine theories, methods, techniques, etc. It has close content relationships with Chinese medicine. What is the influence of Chinese medicine on Tibetan medicine? What is the historical relationship between Tibetan medicine and Chinese medicine?
- As discussed above, if a field is to be qualified as an independent professional medicine, it should be equipped with established, comprehensive, independent, distinguished, consistent, complete and systematic principles, theories, diagnostic techniques and treatment methods that are significantly different from other independent professional medicines. Does Tibetan medicine have its own principles, theories, diagnostic techniques and treatment methods significantly different from Chinese medicine?
Further study and research are needed to clarify the above questions.
Ayurveda is a system of healing practiced in India. There are, however, many questions surrounding Ayurveda:
- The basic concept of prana in ayurveda is similar to the concept of qi in Chinese medicine. The basic principles of ayurveda are similar to several basic principles and philosophies of Chinese medicine such as Five Element theory, yin-yang theory, and yi jing. The three doshas in ayurveda are similar to a condensed form of the Five Elements in Chinese medicine, which is a derivative of yi jing.4,9
The essence of Five Element theory, yin-yang theory, and yi jing in Chinese medicine is to lay out a foundation for the classification of the universe, world and human body. Although there are some differences in nomenclature of the Five Elements used in ayurveda, the fundamental principle of world classification is similar between ayurveda and Chinese medicine. The constitutional remedies of ayurveda are similar to several branches of Chinese medicine such as dietary therapy, medicated food therapy, exercise medicine, psychotherapy, preventive medicine and rehabilitation therapy. The clinical remedies of ayurveda are similar to a few branches of Chinese medicine such as gong xia fa, cui tu fa, guan chang therapy, ci xue therapy, etc. The treatment principle of ayurveda - "to restore balance" - is exactly the same as the treatment principle of Chinese medicine.4
In short, there are many similarities between ayurveda and Chinese medicine. Based on the close territorial relationship between China and India, it's very likely to raise the following questions: Are there any influences between ayurveda and Chinese medicine? If so, in which direction were the influences exerted between the two medicines? - Chinese medicine's theories and principles were based upon ancient China's philosophies, and were developed within China without the introduction of other medicines.1 Therefore, the Chinese medicine theoretical system is a closed medicinal system. For this reason, ayurveda either developed independently, or developed from Chinese medicine. Is there any influence of Chinese medicine on ayurveda?
- It was reported that more than 2,300 years ago, India regarded pain as a demon that was God's punishment on human beings. In other words, India did not have a mature medicine for pain treatment at that time. However, by that time, Chinese medicine already had comprehensive practice and a complete theory (neijing, etc.) on pain treatments in addition to treatments for many other diseases and illnesses. Is the above report true? Did Chinese medicine develop earlier than ayurveda?
- The primary emphases in ayurveda are on disease prevention and promoting longevity. Treatment of illness is an important secondary aim. Ayurveda is considered to be potentially more effective when it addresses illness early in the disease process, before extensive tissue and organ damage has occurred. Ayurveda generally does not address such problems as traumatic injuries, acute pain and advanced diseases.9 This is different from Chinese medicine, which is a full-spectrum medicine concentrating not only on disease prevention, but also on treatments for all diseases. Chinese medicine also is effective for illnesses at all stages. It's very effective in treating traumatic injuries, acute pain and other advanced diseases that ayurveda generally does not address. From this viewpoint, Chinese medicine is more complete, comprehensive, systematic and advanced than ayurveda. Is the above situation true?
- Ayurveda is a spiritually based medicine and primarily a self-healing system. Some say ayurveda works slowly,4 which is similar to parts of Chinese medicine. However, besides the spiritual, mental and self-healing components, Chinese medicine also contains very large branches of materially and physically based medicine. Chinese medicine can work quite quickly for many diseases and illnesses. In this sense, Chinese medicine covers ayurveda, and is much more comprehensive than ayurveda in theory and practice. Is the above situation true?
- Ayurveda is similar to several branches of Chinese medicine, and Chinese medicine contains more branches not available in ayurveda.9 In other words, Chinese medicine covers ayurveda in content. Was ayurveda developed under the influence of these branches of Chinese medicine?
- Ayurveda uses Chinese herbs and local herbs. As mentioned above, using local herbs does not qualify a medicine as being an independent professional medicine. If the applications of the local herbs in countries outside China still follow the holistic theory of Chinese medicine, they should belong to the holistic Chinese medicine system. What's the medicinal relationship between Chinese medicine and ayurveda?
- India is one of China's direct neighbors. Most Asian nations, including those not directly neighboring China, either use Chinese medicine directly or have used branches or derivatives of Chinese medicine for hundreds and thousands years. If most other Asian countries use Chinese medicine, is it possible that India, which has the closest territory relationship with China, makes an exception by not using Chinese medicine in an environment where most other Asian nations do? Is it possible that, similar to other Asian nations, India also introduced Chinese medicine, either directly from China or indirectly through other Asian nations surrounding India that use Chinese medicine?
- The complete theory of Chinese medicine was established more than 2,300 years ago. However, the practice of Chinese medicine was traced back to the Peking Man era of 600,000 years ago. It's reported that ayurveda has been practiced for 5,500 years.9 Is it true that ayurveda was developed later than Chinese medicine and under the influence of Chinese medicine?
- As discussed above, if a field is to be qualified as an independent professional medicine, it should be equipped with established, comprehensive, independent, distinguished, consistent, complete and systematic principles, theories, diagnostic techniques and treatment methods that are significantly different from other independent professional medicines. Does ayurveda have its own principles, theories, diagnostic techniques and treatment methods that differ significantly from Chinese medicine?
Further study and research are needed to clarify above questions.
Evidence-based medicine is a relatively new term. Currently, there are about a dozen definitions for this term, and a consensus has not been reached yet.10 No matter what the final definition will be, evidence-based medicine is an inclusive medicine. It includes all medicines of valid clinical and/or experimental evidence. Therefore, it is vague, non-specific, and cannot be used to describe independent professional medicines.
We have discussed some current major systems of medicine. There are many other medicinal systems that have not been discussed. Due to space limits, we will not cover them here. However, the principle is similar: Any claim of a new medicine needs rigorous scrutiny before being justified as a new medicine. In respect of academic integrity, there is no double standard. Any clouds over academic integrity should be cleared, no matter what medicine is involved.
Today, Chinese medicine - the world's earliest comprehensive, systematic, complete, effective and safe medicine - already has become a treasure of entire human beings. As a result, how to protect Chinese medicine actually has become a test to the human civilization. If a civilized world let the questions raised here go without further scrutiny, it would set an unprecedented example in human history. This could seriously jeopardize academic integrity and would become a major setback to the entire human civilization. Therefore, to protect Chinese medicine actually is to protect the foundation and framework of human civilization.
Classification of Medicines
Based on the above evaluation of medicines, current medicines can be classified into three categories.
1. Independent Professional Medicine
Independent professional medicine (IPM) refers to those medicines having established, comprehensive, independent, distinguished, consistent, complete and systematic principles, theories, diagnostic techniques, and treatment methods, etc. that are of significant differences from other independent professional medicines.
Based on the above discussion, currently only Chinese medicine and Western medicine qualify as independent professional medicines. Oriental medicine, Asian medicine and Eastern medicine are inappropriate synonyms of Chinese medicine, and should be discontinued.2
2. Group Medicine
Group medicine (GM) refers to those medicines consisting of many component medicines. Currently, the following medicines fall into the category of Group medicine:
(1) Alternative medicine;
(2) Complementary and alternative medicine (CAM);
(3) Integrative medicine;
(4) Evidence-based medicine.
These group medicines tend to be inclusive and descriptive, and do not have a clear extension as to how many medicines are included within them. They also do not have rigorous criteria as to what kind of medicines should be included within them. They also lack coherent, comprehensive, independent, distinguished, consistent, complete and systematic principles, theories, diagnostic techniques, and treatment methods. Therefore, they cannot be used to describe independent professional medicine.
3. Indefinite Medicine
Indefinite medicine (IM) refers to those medicines bearing questions that need to be clarified. They usually have a close relationship with a pre-existing independent professional medicine, but have not been proved and justified as independent professional medicines.
Further study and research is needed in order to clarify whether they belong to the category of independent professional medicines, or are just branches or derivatives of a pre-existing independent professional medicine. Examples of indefinite medicine include chiropractic, naturopathy, homeopathy, Tibetan medicine and ayurveda. Based on the results of further study and research, these medicines may be classified as independent professional medicines, or as a branch or derivative of other independent professional medicines.
Conclusion
In this part of the Unified Medicine Project, we have discussed the problems that exist in medicine, presented the goal of Unified Medicine Project, proposed the concept of independent professional medicines, reviewed the major medicines that have existed in history, and classified existing medicines.
From the above discussion, we can see that at the current stage, only Chinese medicine and Western medicine are qualified to be independent professional medicines. Other "medicines" have many questions surrounding them, have generated many questionable historical gaps, and need further study and research in order to clarify whether they can be classified as independent professional medicines.
One goal of the Unified Medicine Project is to call attention for the international communities in medicine, science and history to undertake rigorous scientific scrutiny on the questions raised in this article, and to fill those historical gaps in order to protect the integrity of science and medicine. Another goal of this project is to establish the framework of future medicine - Unified Medicine - that will benefit patients and the public the best. The ultimate goal of this project is to set up a unified theoretical and clinical system for medicine. This will reduce the chaos in medicine, improve efficacy and safety in practice, and will help patients and the public to get access to the most appropriate medicine quickly and efficiently, which will save their time and lives in having access to medical treatments.
In an era dominated by the pharmaceutical industry and their interests, one would expect to see a strong opposition by the industry to have a successful project of this type. We might be unable to see it realized in our generation. However, if it is the right thing to do, we should start it now.
Feedback
The Unified Medicine Project has touched many important issues in medicine and history. Due to this reason, the American Chinese Medicine Association (ACMA) has tried to make the project as accurate and factual as possible. However, due to the breadth and depth of the project, and due to the limit of the author's knowledge, errors and mistakes are unavoidable. The author is open to any corrections as long as they respect facts and the truth.
ACMA welcomes all feedback that is constructive in promoting the integrity and advancement of science and medicine.
Technical Feedback
In order to resolve the questions raised in this article, more technical details on related historical events are needed. If you have information, data, references, comments and suggestions on technical details such as specific times, places and persons of important historical events involved, please direct your feedback to info@americanchinesemedicineassociation.org. For the purpose of accuracy, please attach references to all technical feedback.
Other Feedback
As a concluding remark, we would like to point out that the Unified Medicine Project has neither provided answers nor drawn conclusions on the questions raised in this article. Therefore, for all other feedback, the questions you have are probably the same questions ACMA has. The answers you are looking for are probably the same answers ACMA is searching for. We all are waiting for history to provide final answers and make final conclusions.
Acknowledgements
The Unified Medicine Project was initiated in 2002 soon after submitting its Letter to the U.S. Congress.1 Since then, the author has obtained comments and opinions from many professionals. The author would like to give thanks for the valuable comments a
