Shen, Qi, Jing - Keeping Our Medical Theory Intact

Now that the public and many biomedical professionals have accepted the value that acupuncture and Traditional Chinese Medicine bring to the healthcare system, it's time our profession acknowledges that TCM survived into the modern era not because we assimilated into the dominate healthcare model, but because we are different from it. Our system hasn't proven itself through double-blind randomized studies, but through clinical effectiveness.

TCM is a medical system based on Shen, Qi, and Jing, loosely translated here as mind/body/constitutional inheritance. The Western medical system focuses much more narrowly on biology, the body. It is because of this difference the methods and measurements used to prove effectiveness for bio-medicine create fatal errors when used in the application of Chinese medical theory.

To remain vibrant and effective our medical system must remain rooted in the principals, discipline and language that brought it this far. Our peculiar professional language expresses concepts, which are necessary for accessing our theory. Attempts to Westernize our language and use Western style studies to prove our place in the healthcare system will likely reduce our effectiveness and discredit our medicine rather than advance it.

Consider this, Dr. Bong Dal Kim, OMD, founder of Emperor's College of Traditional Oriental Medicine, greets every incoming class with the same message: "If you want to be a superior doctor you must know your own Shen." Shen (spirit-intelligence) is a key concept in TCM and emphasized to novices immediately. Shen, Qi and Jing, we are taught are the Three Treasures and must be guarded and kept in balance for a human to be healthy.

In the Western health system the idea that, Shen, a non-tangible, non-measurable concept could have any effect on the practice of their medicine would be considered ridiculous. Similarly Western physicians do not take a person's Jing into consideration when writing a prescription. For the most part set protocols exist regardless of the age or constitutional profile of the patient.

Of the Three Treasures the Western bio-medical system addresses only one - qi, the physical form (within the context of the Three Treasures, qi refers to the physical body itself, filled with Shen, and rooted in Jing.)

Western medicine and the scientific method have self-selected to focus solely on biology. Therefore, scientific methodology consists of constraints based on the five physical senses, measurable data, and repeatable results. Experiments or studies which do not meet the set criteria are considered to be unscientific and therefore not useful.

However, in spite of randomized, double-blind studies it has proven impossible for a Western scientist to eliminate the placebo effect from their studies. The placebo effect, statistically always present, in fact is the scientific proof of the existence of a mind/body connection.

In comparison for the Oriental medical system Shen, Qi and Jing are metaphorically three legs on a three-legged stool, if you remove one leg the stool will not stand. When scientific method demands we remove Shen and both the patient and the practitioner from the equation when creating a study, it stops us from practicing our medicine.

We are trained to think and treat always considering Shen, Qi, and Jing. We are taught that emotions can be and usually are the etiology of internal diseases. We know that emotional imbalances of anxiety or depression are generally caused by dysfunction in the qi, and that a weak constitution or Jing is often the precursor to this dysfunction.

By narrowing focus within strict scientific parameters scientist have made many amazing bio-medical advances, which should be applauded. However, the Western bio-medical system albeit a heroic system is also somewhat blind to what takes place outside their parameters. This metaphoric blindspot is the niche where our medicine operates well.

Therefore, it is an unreasonable assumption that our medical system's effectiveness can or should be measured by the same standards as the bio-medical system. They are two completely different systems that can compliment quite well.

Paul Kadetz, past consultant to the Traditional Medicine Unit of the World Health Organization, trained acupuncturist and nurse, and co-editor of the journal Asian Medicine: Tradition and Modernity, said it best. In a recent Acupuncture Today article Kadetz was quoted as follows: ". . . as long as the practice and management of TCM doesn't fall into the trap of merely trying to mimic biomedicine then maybe we can continue to see acupuncture and TCM fill a much needed niche in healthcare that biomedicine as currently practiced does not always fill."

The double-blind, randomized studies created specifically to minimize the effect of Shen and to disregard Jing cannot be used to verify an approach that states upfront as a core principal Shen and Jing are integral, indivisible parts of whole human. By eliminating Shen, scientific studies in a sense knock one leg off of a three-legged stool and then claim three-legged stools don't work.

Meta-analysis of case studies and clinical trials remain viable methods of determining effectiveness and should be undertaken. However, the notion that there is an advantage to adapting Western language or scientific standards needs to be closely examined.

We need to listen to leaders in our field who suggest we adhere to our own medical paradigm rather than attempt to imitate Western biomedical doctors.

Will Morris, DAOM, L.Ac, for example in his recent Acupuncture Today article "Scope and Standards for Acupuncture," discussed the 2004 Little Hoover report conclusion that patients benefit when healthcare givers use a common Western-based language. In his conclusion Morris made it clear he does not recommend this approach, "In my opinion, it is not possible to effectively practice Chinese medicine without the language of the discipline, especially in the context of herbal and nutritional management," he wrote.

In his book, "Statements of Fact in Traditional Chinese Medicine" author Bob Flaws stresses that understanding of the concepts and the language of TCM is necessary to access and apply Chinese theory in a "logical orderly fashion." If we lose our language, we lose our theory and then we are grasping at straws not reasoning like Chinese physicians.

TCM is a logical and orderly system of medicine and we need to hold on to our language and our theory if we will practice in a logical orderly fashion. Though we may need to switch out of our specific language in order to interface with biomedicine at times, we owe it to the great physicians who shaped this medical system over thousands of years to keep the theory intact.