Convergent Lines of Descent: Symptoms, Patterns, Constellations, and the Emergent Interface of Systems Biology and Chinese Medicine

Thinking differently with Chinese medicine: 'Explanations' and case studies for a postcolonial STS

In Mandarin, the English word 'nature' translates as 'ziran' (zìrán) in science, biomedicine and everyday life. At the same time, ziran indexes a second older set of meanings that make little immediate sense in English. Current in many Chinese medical practices as well as in classical Chinese philosophy, these include 'what is spontaneously so' or 'let the character of the self unfold'. In this article we explore how these two families of meaning are related by particular Taiwanese Chinese medical practitioners as they describe how they negotiate the relations between biomedicine and Chinese medicine in daily professional practice. At the same time, inspired by related logic-shifting writing in anthropology, postcolonial studies and postcolonial STS, we draw on the 'art of patterning' ( biàn zhèng) to understand how ziran-nature relations are specified in those accounts. Patterning is the art of specifying the shifting arrangements and misalignments that lead to ill health. Treating this as a way of thinking about ziran-related overlaps between biomedicine and Chinese medicine, we show that patterning attends not to objects 'out there' but to appearances (xiang, xiàng). Put into use as an STS term of art it therefore shifts the epistemological basis of inquiry because case-stories no longer reveal underlying mechanisms, but instead narrate patterned appearances. One implication of this is that any particular pattern diagnosis lies alongside a galaxy of alternatives that might be equally good to think with. Within the limits set by referential academic conventions, we thus attempt a postcolonial shi ()-inflected STS in this paper by resisting the use of a single analytical framework, instead setting different forms of patterning alongside one another.

A Critical Essay on the Historiography of East Asian Medicines: New Horizons beyond Dichotomy and "Tradition"

One of the main topics discussed by historians, including those of science, in the late twentieth century is the historical introspection into "modernism," a term based on a teleological view of the world. According to the conventional understanding of world history, the historical process to modernity that has led to the Civil Revolution, Scientific Revolution, and Capitalism is linear and universally inevitable, and this-in other words, Eurocentrism-implies that only the historical experiences of Europeans are relevant. This mainstream view of world history has spread the dichotomous analytic framework of historiography and reinforced cultural essentialism, which has eventually given a Euro- or Sino-centric hierarchical presentation of history. This type of world view rests on the assumption that there are intrinsic and incommensurable differences between cultures or localities, which a lot of commentators and scholars have constantly countered by arguing that that presumption does not comply with what historical sources say. Drawing on some trail-blazing scholarship of cultural studies and others, this essay turns away from this "conventional" framework of historiography and presents a world view that is framed in the context of trans-locality, interconnectedness, plurality, heterogeneity, polycentricity, and diversity. In recent years, in an attempt to search for new analytic frames, some endeavors have emerged in the field of cultural or science studies to go beyond just providing critical commentaries or case studies. Furthermore, researchers and scholars in the history of science, technology and medicine in East Asia have put an effort into conceptualizing and establishing such new analytic frames. Among those approaches are attempts to shed light upon the trans-local yet global interconnectedness (emphatically in pre-modern periods), diverse historical trajectories to modernities, and polycentric as well as plural landscape of scientific enterprises over time and across the world. On top of these new visions of world history, this essay further elaborates on and proposes some conceptive ideas: (1) "Tradition" as a set of recipes, which could replace the idea of the living yet dead tradition; (2) "Medicine" as a problem-solving activity, which calls more attention to historical actors of East Asian medicine; (3) "East Asian medicines" as a family of trans-locally related practices in East Asia, which would lead to going beyond the nationalist historiography such as Sino-centrism; (4) "Problematique" as the system of questions and concepts which make up East Asian medicine, which should reveal what East Asian medicines have been about; (5) "Styles of Practice" for the historiography of East Asian medicines, as opposed to the cultural account, epistemological historiography or praxiography; and, as an illustrative example, (6) "Topological Bodies" for the history of anatomy in East Asia. Going beyond tradition and dichotomous historiography, these new methodologies or conceptual ideas will contribute to the understanding of the history of East Asian medicines.

A qualitative study of classical Chinese medicine in community health focusing on self-care: practitioner and staff perspectives

Introduction

Classical Chinese medicine (CCM) encompasses many simple lifestyle recommendations which can be adopted into daily routines in support of short and long-term health outcomes. The rise in non-communicable diseases (NCDs) globally in recent decades has led to a need for cost-effective and scalable health care interventions to address lifestyle risk for NCDs in the community. This analysis explores the experience of staff and practitioners delivering a CCM community health care program designed to improve health behaviors in the community in rural Scotland.

Methods

A qualitative study employed semi-structured interviews with a sample of program practitioners and staff (n = 7). Informants were asked to share their experience in delivering the CCM program. Emergent themes were identified via analysis using the Framework Approach.

Results

Themes emerged from the data in three key areas: Cultural challenges within the local region; Integration with the existing local health care network; and Team dynamics, co-creation and communication integrity.

Conclusion

This study highlights the importance of accessibility, integration, networking, secure funding and team unity in the context of community health program delivery, as well as noting a diversity of practice among Chinese medicine practitioners. CCM concepts may hold potential for integration into community health, however, further research is warranted.

Situating biologies of traditional Chinese medicine in Central Europe

Since the concept of 'local biologies' was proposed in the 1990s, it has been used to examine biosocial processes that transform human bodies in similar and different ways around the globe. This paper explores understandings of biosocial differentiation and convergence in the case of Traditional Chinese Medicine (TCM) in the Czech Republic. Specifically, it examines how Czech TCM practitioners view TCM as universally applicable while fine-tuning it to situated biosocial conditions, experimenting with the compatibilities of various human and plant bodies as part of their generalised, clinical practice. Drawing upon ethnographic research among TCM practitioners in the Czech Republic, it suggests that in addition to the individualization of TCM therapeutics to suit particular patients, Czech TCM is characterised by collective particularization, shaped by local concerns over ethnic, environmental and cultural differences. By looking critically at TCM practitioners' sensitivities to localised biological similarities and differences it aims to contribute to understandings of the expansion of TCM in Central Europe, as well as more broadly to current social science debates over the risks and opportunities inherent in abandoning the assumption of a universal human body and biology.

Standard Protocol Items for Clinical Trials with Traditional Chinese Medicine 2018: Recommendations, Explanation and Elaboration (SPIRIT-TCM Extension 2018)

Traditional Chinese Medicine (TCM) is one of the oldest systems of medicine. More and more attention has been paid to TCM application, but the variable quality of clinical trials with TCM impedes its widespread acceptance. The Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 Statement has established guidelines for designing clinical trials to ensure that the trial results are accurate and reliable. However, there are difficulties when applying SPIRIT 2013 Statement to trials with TCM, due to the unique theory and the characteristic of TCM intervention. An Extension to the original SPIRIT was developed to ensure the quality of trial design with TCM. As Chinese herbal formulae, acupuncture and moxibustion are common and representative interventions in TCM practice, the executive working group determined that the SPIRIT-TCM Extension focus on these three interventions. Extension was developed through initiation, 3 rounds of Delphi consensus survey, and finalizing expert meeting. Seven items from the SPIRIT 2013 Statement were modified, namely, "title", "background and rationale", "objectives", "eligibility criteria", "interventions", "outcomes", and "data collection methods". The Extension includes the introduction of the concept of TCM pattern and 3 major TCM interventions, with examples and explanations. The SPIRIT-TCM Extension 2018 provides suggestion for investigators in designing high quality TCM clinical trials. It is expected that wide dissemination and application of this extension ensure continuous improvement of TCM trial quality throughout the world.

The Case of the Suzhou Hospital of National Medicine (1939-41): War, Medicine, and Eastern Civilization

This article explores the founding of the Suzhou Hospital of National Medicine in 1939 during the Japanese occupation of Suzhou. We argue that the hospital was the culmination of a period of rich intellectual exchange between traditional Chinese and Japanese physicians in the early twentieth century and provides important insights into the modern development of medicine in both countries. The founding of this hospital was followed closely by leading Japanese Kampo physicians. As the Japanese empire expanded into East Asia, they hoped that they could revitalize their profession at home by disseminating their unique interpretations of the famous Treatise on Cold Damage abroad. The Chinese doctors that founded the Suzhou Hospital of National Medicine were close readers of Japanese scholarship on the Treatise and were inspired to experiment with a Japanese approach to diagnosis, based on new interpretations of the concept of "presentation" (shō / zheng ). Unfortunately, the Sino-Japanese War cut short this fascinating dialogue on reforming medicine and set the traditional medicine professions in both countries on new nationalist trajectories.

Systems Health: A Transition from Disease Management Toward Health Promotion

To date, most of the chronic diseases such as cancer, cardiovascular disease, and diabetes, are the leading cause of death. Current strategies toward disease treatment, e.g., risk prediction and target therapy, still have limitations for precision medicine due to the dynamic and complex nature of health. Interactions among genetics, lifestyle, and surrounding environments have nonnegligible effects on disease evolution. Thus a transition in health-care area is urgently needed to address the hysteresis of diagnosis and stabilize the increasing health-care costs. In this chapter, we explored new insights in the field of health promotion and introduced the integration of systems theories with health science and clinical practice. On the basis of systems biology and systems medicine, a novel concept called "systems health" was comprehensively advocated. Two types of bioinformatics models, i.e., causal loop diagram and quantitative model, were selected as examples for further illumination. Translational applications of these models in systems health were sequentially discussed. Moreover, we highlighted the bridging of ancient and modern views toward health and put forward a proposition for citizen science and citizen empowerment in health promotion.

Cosmic Experiments: Remaking Materialism and Daoist Ethic "Outside of the Establishment"

In this article, I discuss recent experiments in 'classical' (gudian) Chinese medicine. As the marketization and privatization of health care deepens and enters uncharted territories in China, a cohort of young practitioners and entrepreneurs have begun their quest for the 'primordial spirit' of traditional Chinese medicine by setting up their own businesses where they engage in clinical, pedagogical, and entrepreneurial practices outside of state-run institutions. I argue that these explorations in classical Chinese medicine, which focus on classical texts and Daoist analytics, do not aim to restore spirituality to the scientized and secularized theory of traditional Chinese medicine. Nor are they symptomatic of withdrawals from the modern world. Rather, these 'cosmic experiments' need to be understood in relation to dialectical and historical materialisms as modes of knowledge production and political alliance. In challenging the status of materialist theory and the process of theorization in traditional Chinese medicine and postsocialist life more broadly speaking, advocates of classical Chinese medicine imagine nondialectical materialisms as immanent ways of thinking, doing, and being in the world.

The Dangers of 'Warming and Replenishing' (wenbu ) during the Ming to Qing Epistemic Transition

Through a case study of Zhao Xianke's One Principle through Medicine (Yiguan ) (1617?) and Xu Dachun's (1693-1771) denouncements of this text, my article zooms in on divergent discourses on the safety and efficacy of medicinal substances and compounds in late imperial China. Although Xu Dachun's fierce attacks on the popular 'warming and replenishing' (wenbu ) therapies can be situated in an epistemic shift from the cosmology of 'Song learning' (songxue ) towards the philology of 'Han learning' (hanxue ) and 'evidential research' (kaozheng ), I argue that more complex issues were at stake as well. Changed political, social, ethical, and economic realities shaped new and multifaceted perceptions of the nature of medicine, the medical profession, and the usage of medicinals in the aftermath of the Ming to Qing transition.