Current medical treatment emphasises the effectiveness and statistical chances of obtaining good results. Modern medicine has developed as direct corrective measures. Hence when it is effective, the probability of arriving at good results is very high. Unless not available, there is therefore no reason why modern medicine should not be endorsed as the primary mainline treatment.
Although there are still confident herbal practitioners who believe and declare that whatever the modern scientific practitioners can do, they could substitute with other herbal remedies, the number who remain that committed is getting less and less. Indeed today, most herbal practitioners accept the role of functioning as supplementary or alternative healers in a combined effort of cure and care.11
In this context, complementary herbal treatment is seldom used as the only healing modality. Instead, it is often given as an adjuvant treatment, either together with the mainline or after completion of the mainline. Users of herbal preparations, moreover, frequently look forward to a tonic supportive effect, rather than a curative effect.
HOW DOES HERBAL MEDICINE REALLY WORK?
Traditionally the system of herbal medicine was built on the rich experience of herb users or herbalists, accumulated over more than two thousand years in China since the early Chinese culture. For some reason, while basic medical sciences, e.g. anatomy and physiology, developed gradually in European territories around the Renaissance period, Chinese healers never felt the need to explore these basic medical sciences. Without sound knowledge of anatomy and physiology, i.e. biological structure and function of the human body, it would not be possible to explore abnormal structures and functions, i.e. pathology. Without understanding the pathology, it would not be possible to apply a direct means of removing the pathology. Herbal practitioners therefore try to heal, not by direct confrontation with the pathological problem, but by indirectly supporting the individual to overcome his own difficulties.1213
HOW DOES THE INDIVIDUAL OVERCOME HIS OWN PATHOLOGICAL PROBLEMS?
Firstly by surviving the harmful disturbances imposed by the pathological processes. Secondly by supporting the unaffected organs and systems in their proper functions. Thirdly by preventing future pathological mishappenings while the current problem is being solved.
The herbal practitioner has means to suppress the symptoms which are manifestations of the pathology. Suppression of symptoms like cough, diarrhoea or dyspnoea helps the sick individual to survive.
While waiting for the pathological damages to heal naturally, the unaffected organs and systems need to be supported to maintain their efficient function, which in turn will support the overall function and metabolic harmony of the living individual.
Prevention in the modern biological sense frequently refers to an immunological mechanism through which the individual becomes more resistant to future attacks of similar pathological nature.
The main focus of disease management for Chinese medicine is often the control of adverse symptoms. The ultimate goal is maintaining the well-being of the biological system. The aeti-ological consideration is therefore not directed towards the actual cause of the disease (of which the herbal expert has no idea), but a general conceptual state of the biological balance of the human bodily functions. The ancient healers correlated this conceptual state with the Taoist philosophy and imagined that bodily function was kept at a balanced state between Yin and Yang (i.e. negative and positive). Any loss of balance led to ailment and disease.
The aim of treatment is therefore to maintain the balance. Yin and Yang includes other contrasting opposing forces like cold and heat, superficial and deep, empty and solid. The causes of imbalance could be traced to a lack of balance of any pair of opposing forces. In the actual treatment, therefore, all efforts are spent on the maintenance of balance, by a supplement of the deficient force, or a decrement of the excessive.
Since the pathological causes of the symptomatology are unclear to the herbal expert, he would need to observe the changes of symptoms and adjust his day-to-day protocol accordingly. This approach differs very much from conventional modern medicine, which successfully identifies a pathological cause of disease, chooses a method of cure with good chance of success, then administers it with all effort and commitment, until the total removal of the pathology is achieved.
While the aetiology, epidemiology and natural course of a disease affect the design of clinical trials for modern medicine, it is now clear that in Chinese medicine, there is little analogy of aetiological and epidemiological considerations. The course of events in a disease, for a herbal expert, is the appearance of the symptoms: the loss of biological well-being due to the lack of balance between the vital forces. The aim of treatment is the re-establishment of balance; once balance is re-established, either naturally or through herbal intervention, well-being will be re-established. Treatment consists of a dynamic application of symptomatic relief with the goal of re-establishing the balance.14
Clinical trials for Chinese medicine or herbal medicine therefore could follow the line of thought for scientific planning on data collection and subsequent data meta-analysis. However, the pre-treatment data would be confined mainly to symptomatology. Other parameters would carry little weight for the herbal expert; but could still be included for more scientific knowledge in clinical trials.
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