The following letters were written in response to " Scientific Criticism of Traditional Oriental Medicine: Reflections Following Conversations With My Twin Brother" by Jake Paul Fratkin, OMD, LAc, which appeared in the August issue.
I applaud Dr.
Jake Paul Fratkin's excellent essay on the blind spots inherent in the current scientific criticism of Oriental medicine. I feel that one of his points needs further refinement and elaboration, however.
Regarding point #3, "The Lack of Modern Scientific Explanation," one needs to make clear what is meant by the statement, "Because Western medicine employs the language of biochemical physiology, it is unable to understand the mechanisms utilized in acupuncture energetics, such as qi, yang and yin, and acupuncture channels." The semantic, epistemological and clinical divide being pointed at here is one between a system that analyzes objects (biomedicine) and one that analyzes relationships (OM). Yin and yang exists only in relationship to each other; the five elements cannot be extracted from their generating/controlling cycles.
While biomedicine acknowledges the existence of systems in the body, it does so only within the context of groupings of separate, self-contained components and organs, each of which is itself a mere grouping of cells and discrete functions. Given the amount of information contained in such groupings, the sum total of all of the interactions of the component parts, as well as the sum total of those reactions with the components of all other systems in the body (never mind the sum of those reactions with the environment outside the body system), is impossible to analyze. Not even the most powerful supercomputer has the resources to stimulate the total of all individual reactions in the human body. This analysis of the body as system is biomedicine's blind spot, a direct result of its reductionist, linear paradigm. Biomedical clinicians, when faced with the seemingly infinite data available from the body, must necessarily exclude most of the data in order to form a coherent diagnosis and treatment. Thus, pharmaceuticals and surgery have "side-effects" which are accepted and generally disregarded, unless potentially fatal or so severe as to affect patient compliance.
Contrast this with Oriental medicine, where there is no concept of the "side-effect" - a regrettable, but tolerable and ultimately inconsequential nuisance - only health effects, vectors of balance or imbalance to which the OM clinician must pay scrupulous attention or risk injuring the patient. The reason such care can be taken is a direct result of the epistemological lens, reflected in its terminology, it applies to human health. By giving the clinician a descriptive and poetic terminology that describes functional relationships, it makes full use of the information synthesizing and pattern-differentiating capabilities inherent in the human mind (as opposed to the number-crunching capability of a computer). OM terminology thus can be employed to accurately predict both pathology and prognosis simultaneously across all systems of the organism.
Hence, do yin, yang and qi "exist"? Not in the sense that, say, a heart exists in biomedicine, a piece of temporarily animated meat that can be weighed, dissected and analyzed under a microscope. But they do exist as descriptions of functional relationships, as useful categories that can ultimately, in the hands of a trained clinician, effect a certain real, measurable outcome in the treatment of disease. Unlike Dr. Fratkin, I doubt that machines will ever detect such entities, because they only exist in the mind, but the point is moot: the neural networks in our heads can do that already.
Benjamin Hawes, MAOM, LAc Cortez, Colorado
I would like to wholeheartedly agree with Dr. Fratkin on the points in his well-written article. I'd also like to add a few observations.
The idea and the phrase "energy" have been bandied about among physicists, especially now with the advent of quantum physics, so we are not quite as isolated in that respect as we might suspect.
While I value accurate measurement, e.g. "What percentage of patients are helped by this technique?", "To what degree are neurotransmitters altered by that method?", "How much less time does a bone take to heal if our patient is taking X?", etc., I really don't value scientific explanations. We have a culture in which if someone with a scientific background says, for instance, "This is why A occurs. This is why B occurs. Therefore, A + B = C," we take it as the truth. Yet a few months or years down the road, a new explanation comes along and is taken as the truth, debunking the old truth as flawed thinking. So, with truth being so subjective and flexible, is it "truth" or merely perspective? While modern allopathic medicine is backed up by many of these very malleable scientific truths, many of its treatment modalities are not backed up by accurate measurements, as they claim to be. I personally have a soapbox for each of my own truths regarding several of these modalities.
Yes, I do believe a great strength of modern allopathic medicine, when well performed, is in the field of trauma and critical care. And let's not forget AOM's place in that context. In my own practice, I have used acupuncture to successfully treat patients in what modern medicine would call acute respiratory failure, acute heart failure, seizures or MI in progress. Many patients have strokes who, had they been in a hospital prior to TPA (tissue plasminogen activator, a "clotbuster") would merely have been diagnosed and observed, and not necessarily treated.
Explanations of how AOM works will come and go; we'll get new explanations decade after decade. Our own culture within AOM dwells in the traditional language and distinctions that give us access to using it in a way that works. Those distinctions have taken millennia to evolve.
My number one concern in this is that our patients have fulfilled lives. As long as our own traditional/classical scientific explanations of what we do provide for AOM powerfully contributing to that end, I'm satisfied. Thanks, Jake!
Robert Murdoch, AP Cape Coral, Florida
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