Tue, Oct 13, 2015 page9

• Nobel prize might bring reconciliation with Chinese medicine

  • By Ian Johnson / NY Times News Service, BEIJING
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  As China basks in its first Nobel prize in science, few places seem as elated, or bewildered, by the honor as the China Academy of Chinese Medical Sciences.

  Located on a shady street in Beijing’s Old City, the academy is spread over a city block and welcomes visitors with an incongruous juxtaposition: A 2m-high quotation from Chairman Mao Zedong (毛澤東) facing bronze statues of gowned doctors from antiquity who devised esoteric theories to heal the human body.

  These contrasts are part of a bigger, century-long debate in China that has been renewed by the award given on Monday last week to one of the academy’s retired researchers, Tu Youyou (屠呦呦), for extracting the malaria-fighting compound Artemisinin from the plant Artemisia annua. It was the first time China had won a Nobel prize in a scientific discipline.

  Traditionalists say the award, in the physiology or medicine category, shows the value of Chinese medicine, even if it is based on a very narrow part of this tradition.

  “I feel happiness and sorrow,” said Liu Changhua (劉長華), a professor of history at the academy. “I’m happy that the drug has saved lives, but if this is the path that Chinese medicine has to take in the future, I am sad.”

  The reason, he said, is that Tu’s methods were little different from those used by Western drug companies that examine traditional pharmacopoeia around the world looking for new drugs.

  In fact, in its award, the Nobel committee specifically said it was not honoring Chinese medicine, even though Artemisia has been in continuous use for centuries to fight malaria and other fevers and even though Tu said she figured out the extraction techniques by reading classical works.

  Instead, it said it was rewarding Tu for the specific scientific procedures she used to extract the active ingredient and create a chemical drug.

  However, the most sophisticated part of Chinese medicine, Liu said, involves formulas of 10 to 20 herbs or minerals that a practitioner adjusts weekly after a consultation with a patient. And yet almost no research has been done on how these formulas actually interact with the body, he said. Instead, the government has poured money into finding another Artemisinin — with no luck.

  “Are we truly respecting this cultural heritage?” Liu said.

  “When we think Chinese medicine needs to be modernized and the path it shall go down must be like Tu Youyou’s path, I think it is a disrespect,” he said

  However, many Chinese think it should not be respected at all. Scientists like He Zuoxiu (何祚庥), a member of the prestigious Chinese Academy of Sciences, say the ancient pharmacopoeia should be mined, but the underlying theories that identified these herbs should have been discarded long ago.

  “I think for the future development of Chinese medicine, people should abandon its medical theory and focus more on researching the value of herbs with a modern scientific approach,” He said in an interview.

  These radically different views on Chinese medicine go back at least a century and get to the heart of how modern China sees itself.

  After a series of lost wars and national humiliations, Chinese reformers and revolutionaries began jettisoning almost everything from the country’s long past: its political and religious systems, its architecture and urban planning, its national dress and its lunar calendar.

  Traditional medicine came in for especially harsh criticism. Some of the country’s most famous writers, like Lu Xun (魯迅), Lao She (老舍) and Ba Jin (巴金), pilloried it as exemplifying everything wrong with the country. Its theories were obscure, its outcomes unproven and most of all it was “unscientific” in a country that was beginning to worship science as the cure to all ills.

  “Everyone at that time agreed that Chinese medicine had no future,” said Paul Unschuld, a historian of Chinese medicine at the Charite Hospital in Berlin.

  “Ideas like yin-yang, the Five Elements — all of that was considered backwards,” he said.

  However, when the Communists took over China in 1949, the country had few Western hospitals. A few years later, Mao declared that “Chinese medicine and pharmacology are a great treasure house.”

  The praise, though, came with a caveat: It must modernize. That meant setting up traditional Chinese hospitals, schools and research facilities like the academy in Beijing, but money has flowed overwhelmingly toward Western medicine. In the Mao era, rural healthcare workers — “barefoot doctors” — were often traditional practitioners, which raised the profile of Chinese medicine. After Mao’s death and with growing prosperity, the government doubled down on Western medicine.

  Today, China has 1.1 million certified doctors of Western medicine, versus 186,947 traditional practitioners. It has 23,095 hospitals, 2,889 of which specialize in Chinese medicine.

  “It’s part of the nation, but the nation of China defines itself as a modern nation, which is tied very much to science,” said Volker Scheid, an anthropologist at the University of Westminster in London. “So this causes a conflict.”

  The conundrum was on display on Friday last week at a hastily called news conference hosted by the academy’s Institute of Chinese Materia Medica, where Tu worked. Chinese reporters had been badgering the institute for days for information on Tu. Finally, late on Thursday night, officials announced the briefing.

  For an hour, Chinese journalists asked two officials from the institute for any sort of information on Tu: What was she like (blunt and hard-working), how many were on her team (50), why was she asked to head the project (no one could say).

  Mostly, they asked what she had done in the 40 years since her discovery. The answer came after a bit of shuffling and grimacing: She had tried to find other herbs, but had not succeeded.

  In a nearby clinic attached to the academy, doctors said they know why. Chinese medicine almost never uses individual plants or minerals. Instead, it relies on diagnoses based solely on the doctor’s questions, observations and the skillful taking of the pulse.

  One senior practitioner, Hu Xin (胡新), 61, began learning herbal medicine 50 years ago from his father. He later went to university, earning advanced degrees, but said any good herbalist has to study the classics, some of which date back 2,000 years. Sitting in his small consultation room at the end of a long morning, Hu had just treated 14 patients with serious ailments like intestinal inflammation, ovarian cysts, menstrual cramps and chronic bronchitis.

  However, despite the successes he and his patients report, he worried about the attacks on Chinese medicine. Now, he said excitedly, the Nobel prize would help keep critics at bay.

  “In the future, how can people say that Chinese medicine isn’t scientific?” Hu said. “You can’t deny that it’s based on Chinese medical texts and clinical experience.”
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