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‘We should be stable and firm and confident about who we are. Then, if we find there is no niche for us in this modern world, then that is just too bad.’

An interview with Volker Scheid

Sarah Price asks a leading scholar, practitioner and research there in my school holidays. So you can say that I grew I up with herbs and herbal director about issues such as education, integration and . the place of Chinese medicine and its practitioners in the modern world. How did you get into Chinese medicine? This was the 70s, hippies and left-wing Can I ask you first a bit about your politics. Becoming a herbalist like my background. Where did you grow up? father’s boss appealed to me and I guess I come from Gebhardshain, a little village it also resonated with the spirit of the in Germany. It’s in a very rural area called time. In Germany you can only register as Westerwald that seems to be a terra a Heilpraktiker when you are 26. So after incognita even for most Germans. My father I finished school I couldn’t immediately was a gardener. He grew Western herbs for go for that. Instead, I did various other a very successful Heilpraktiker (practitioner things instead including a two-year of natural medicine), who used only herbs. apprentice­ship as a gardener. The way This person was the closest I have seen to most Heilpraktiker in Germany work is what in Chinese medicine we would call influenced by . That means a laozhongyi. He worked with about 150 that most of them tend to do a bit of different herbal combinations, all of which everything: some , some herbs, he had composed himself, and at the best diet and water therapy, and of times he had about 70 people working so on. Some were also then starting to use for him. He lived in the middle of nowhere . I wanted to become a pure but was phenomenally successful and had herbalist, however, and that is how I came people coming to him from all over the to England when I discovered that one world for treatment. From very early on, my could do a training specialising in herbal father would take me there with him. Later, medicine over here. n Reprinted from the RCHM my mother became the managing director In those days, CAM courses ran only Journal, May 2010, Vol 7 No 1. of this little company, and I used to work part-time and being German, I guess, I

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felt I had to do something more! I looked I was 25, not in my 50s, and I could easily around and stumbled across acupuncture have done my medical training by then. influenced by an existing interest in Eastern philosophies. So, in the end, I studied So if you were starting out now you Western herbs in Tunbridge Wells at the would do medicine first? Western doctors see very College of Phytotherapy, and acupuncture in I would probably do Western medicine and acute diseases, they see the Leamington Spa. Chinese medical thinking sinology at the same time, because when was much more fascinating than I had you are 18 that’s easy to do. You don’t have inside of the body, they see imagined, and acupuncture quite naturally financial commitments at that age, and you people dying, all of which I think‘ are important for led to Chinese . I quickly can really concentrate on studying. So it ’ found out, at least in my own practice, that would be Western medicine and sinology anyone practising medicine. Chinese herbs were much more effective. and then Chinese medicine afterwards, if I So I gave up the Western herbs and just had to do it again. concentrated on Chinese medicine. The problem with Western herbal medicine Can we go on to your research? What for me was that the thinking is based are you involved in? almost entirely on Western physiology and I am the director of the EASTmedicine pharmacology. It gave me a good training in Research Centre at the University of Western biomedical sciences but it also left Westminster, which stands for East Asian me with the feeling that I might as well have Sciences and Traditions in Medicine. studied Western medicine in the first place. The centre is still more of a vision than a finished product but it’s quite an achieve­ What did your parents think? ment, I think, having even got this far. That My parents were supportive, but also a bit vision is a multidisciplinary centre that disappointed that I wasn’t training in a will draw on the humanities, the social more recognised profession. They would and natural sciences, as well as on clinical have preferred me to become a doctor. In practice, and that will foster both teaching retrospect, I think I should have listened to and research. We want to use all the many their advice because being a medical doctor different resources we have available in the gives you important advantages in our development of East Asian , with society without any real disadvantages. You research feeding into teaching, teaching can practise almost anywhere you like. You into practice, and practice feeding back can use more or less what you want in the again into teaching and research. I think it way of herbs, which as we all know is one of is a unique vision with enormous potential the main points that limits our effectiveness because I don’t know of anything similar at present. And I also think because during anywhere else. But turning a vision into their training doctors see very different reality is a difficult undertaking. At the things than we do it gives them a deeper moment, we are looking for more funding understanding, at least potentially, of to develop this potential and that is not easy. disease. They see very acute diseases, they see the inside of the body, they see people So that is going to be for people dying, all of which I think are important for starting out to learn Chinese medicine, anyone practising medicine. I have taught a or research scientists doing PhDs? lot of medical doctors and there is no doubt Ideally everything. We have three postdocs in my mind that this training provides them and one PhD student at the moment, n Sarah Price teaches Chinese with many advantages. That’s why I think and we certainly hope to recruit more. Medicine at the School of it wouldn’t have been a bad thing to study West­minster has Master’s and Bachelor’s Chinese Herbal Medicine Western medicine. degrees in acupuncture and Chinese herbal (London), the London medicine, and this is a good foundation for School of Acupuncture and Wouldn’t it, though, have forged your realising our vision. at the Northern College mind in a certain way? of Acupuncture as Module I actually don’t think so. I think you are What grants do you have at present? Leader on the MSc course in what you are. It would maybe have delayed I was fortunate to get one of the Department Chinese Medicine, as well as certain things, but I started practising when of Health’s research capacity development lecturing abroad.

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grants in Complementary and Alternative invited delegates from all of the UK Chinese Medicine, which is really the basis of the medicine colleges. We would like to expose work I do at Westminster. That grant funded the colleges to cutting edge scholarship my own work on menopause and Chinese in the field and explore what kind of medicine, as well as a PhD student, Trina bridges might be built between these two Ward, who is carrying out an interesting sets of people. Is medical history totally study on the interface of Chinese and bio­ detached from the concerns of teachers medicine. The menopause study is a long- and educators, or can we find a way of Academics, on the other term project involving historical, social integrating history into clinically oriented hand, are often suspicious scientific and clinical research, and I think teaching? Then, next year in August we will of practitioners precisely it has already delivered some interesting organise a symposium that will explore because of their use of findings. the interface of East Asian medicine and history‘ as mythology. Last year I got a three-year project grant systems thinking in the West. ’ from the Wellcome Trust for a transnational history of East Asian medicine about which Do you think, then, that not enough I am very excited. It’s an attempt to look at history is taught when people are the in East Asia in a learning Chinese medicine? way that emphasises networks and flows I think there is not enough history taught across boundaries in order to go beyond and that the history that does get taught the narrow nationalisms that define the and that I read in the introductory sections identity of these medicines at present. of Chinese medicine books on the whole It’s a collaborative effort with researchers is mythological in nature. By that I mean based in China, Korea and Japan and that it is about creating and legitimising will hopefully produce some interesting identities and institutions. I am not publications. interested in this kind of history. What I One of the goals, for instance, is to mean by history is history employed as a show just how influential Japanese critical resource, as a tool that allows us to interpretations of Chinese medicine were reflect on what we do, and that helps us to on the development in modern China of become more competent practitioners and what we now call “traditional” Chinese more critical researchers. medicine. I think research is a tool for In our field it seems to me that people challenging myths and ideologies, and create a rather artificial division between medical tradition defined in nationalist academic study and clinical practice. terms is one such myth. It has little to do Practitioners often seem to think that with how these traditions evolved and I history or other academic work is not really think it disables a more creative practice relevant to clinical practice. If Chinese that would more easily mix elements from medicine developed in a certain way then all the many resources available to us. that must mean that what we do now is the And finally I have a grant from the Arts best Chinese medicine that’s out there. So and Humanities Research Council to set why bother with questioning that? up a Traditional East Asian Medicine Academics, on the other hand, are often Research Network aimed at exploring how suspicious of practitioners precisely the medical humanities might be made because of their use of history as mythology. more relevant to research, teaching and I can see where both sides are coming from also to practice. This has grown from two but I think it is not a very helpful division. previous workshops I ran together with As far as I can see many of the key figures Hugh MacPherson in 2005 and 2007 and in the history of Chinese medicine were will allow us to organise what I hope will sophisticated scholars, very intelligent and be two really interesting events. The first critical people who continuously reflected is a workshop called “The (After)Life of on what they were doing and to whom Traditional Knowledge”, which will take this division between clinical practice place this August at Westminster. It’s a and scholarly or academic work would workshop mainly for historians and science have seemed rather odd. It’s a pity – but studies academics to which we also have also telling – that most Chinese medicine

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practitioners in the West do not know too stuck in the old”. Having just one teacher many of these scholar physicians by name is generally not a very good idea. It easily and even less about who they were and leads to guru worship and that is the op- what they did. posite of what I think Chinese medicine should be about. Confucians say that If you were to study Chinese medicine now from scratch, how would you go How do you become good at Chinese learning has to hurt, that about learning it? medicine? knowledge is difficult to You could almost say every way is wrong, Everybody is different. I think some people acquire. It’s an ongoing struggle‘ and then at some because whatever you do leaves something are just naturally gifted healers. They would ’ out! Certainly learning Chinese, having be good at healing in whatever way they do point hopefully things fall the language is essential from my point it, whether they practise Chinese herbs or into place. of view. If you want to have access to all acupuncture or surgery. Like there are green the resources out there, and I think most hands in gardening, there are healing hands practitioners in the West cannot imagine in medicine. There is nothing you can do just how rich our tradition is, then there is about that. You are born like that or you are no way around learning Chinese. not. For the rest of us it’s more of a struggle. I think it is the prerequisite for any Confucians say that learning has to hurt, serious engagement with Chinese that knowledge is difficult to acquire. It’s medicine. Not because you cannot become an ongoing struggle and then at some point an effective or good practitioner without hopefully things fall into place. Obviously, it. But I think you cannot seriously claim having good teachers helps. Then again, to be representing something to which some people learn more through books you have no real access. Would we take a and others need to be more guided through Shakespeare scholar seriously whose only direct teaching. access to Shakespeare was based on sketchy Also, we live in a modern world so we need Vietnamese translations of Shakespeare’s to have resources beyond those available in sonnets? If not, what’s different about the Chinese medical tradition. We need to Chinese medicine? be very conversant with Western medicine, Once you have the language and access which as I said makes an ideal foundation to source texts, the next thing has to be to for Chinese medicine. And we also need try to find good clinical teachers. That is to become critical thinkers. I think that the other really important component of history and science studies are important in learning Chinese medicine. To find people this respect because of the many questions who are good clinicians, to sit with them, involved in this rather complicated issue of learn with them, and then in the end go off practising an ancient tradition in a modern in your own way, by combining these two world, and of practising a tradition that resources. comes from a different culture than our own. Like an apprenticeship? Yes, but ideally with more than one person. Did you do an MA before your PhD? Like Ye Tian-Shi, who is often held up as the Well, I actually went back to university and most accomplished clinician in the history did a BA. I wanted to study Chinese but of Chinese medicine. Ye Tian-Shi is said to that would have meant to go to London. I have studied with 17 different masters be- had an established practice in Eastbourne fore his 20s. If you read the introduction to at the time as well as a young family so I the Shang Han Lun, then it says there, too, had to give up that plan. I went to Sussex that the author collected widely from all instead, which turned out to be one of the possible sources to collate his text. I think many fortunate things that happened to me that among all the celebrated doctors in the in my life as even though I was enrolled in history of Chinese medicine there is no one social psychology, I ended up doing courses who did not emphasise this principle of in anthropology and science studies a extensive learning and broad scholarship, lot of the time. That allowed me to go on of “following the ancients without getting to Cambridge to do a PhD in medical

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anthropology, which led to a postdoc in people, which is very rewarding, and on medical history at SOAS. that level we are therefore also incredibly fortunate. I would say, however, that if we You have done very well! want to be taken seriously as a profession I have been quite lucky. The PhD particularly in the way that I think most of us do, then I was very hard work because I had to think we also need to get our own house in continue in full-time practice to support order. And here I need to come back to the myself. But after that I was privileged to get issue of language and academic rigour. Can Can you imagine any funding that allowed me to spend extended you imagine any other academic discipline other academic discipline periods of time in China, where I was able awarding Bachelor or even Master degrees awarding Bachelor or to find some exceptional teachers while where students have absolutely no access even Master degrees where also conducting my own research. It’s not to primary sources? If not, why should students‘ have absolutely easy to practise and study at the same time, we be any different? And how could it be ’ and perhaps it would have been better to possible to get that access without learning no access to primary have spent 10 or 15 years studying before Chinese? So let me ask you a question: why sources? starting to practice. do you think that we do not make learning Chinese compulsory at the very least at Tell me about it. And live your life! Master’s level? I know that it can be done. Yes. On the other hand, I have always found I know of at least one school in the States that practice and academic study mutually that teaches all its students Chinese within enriching and it is quite certain that many the scope of a three-year, full-time program. of the relationships that were crucial for my research in China, for instance, would Well this interview is not about me, but I not have come about without me being a would say, “Because we don’t have to.” practitioner as well, and without having a The question for me is why don’t we want reasonable knowledge of Chinese medicine. to? If we think that Chinese medicine in the West took off in the 1970s then it It comes back to education again is now almost 40 years old. Why do we doesn’t it? That the education isn’t acknowledge the importance of evidence- quite good enough? based research, of self-reflection, of what No it isn’t good enough. But I think not, but apparently still think that learning developing Chinese medicine is about net­ Chinese is unimportant and at the very working as well as education in a narrow best optional? What, for instance, is the sense. We need to create better professional value of research that claims to examine net­works because nobody can do every­ Chinese medicine if we cannot access 99 thing, and there is no reason why they per cent of relevant sources? I think this should. By networks I mean the integration is a really important issue. Practitioners of Chinese medicine into academic life will of course say that you can be a good and professional clinical practice in a more practitioner without speaking Chinese, and comprehensive way than exists at present. researchers will say that Chinese research is It’s very difficult, isn’t it, because the status not reliable. But that is not the point. The of Chinese herbal medicine is very low. It point is about the gap that exists between doesn’t attract resources or people enough what we claim to represent, namely the to make it – without insulting anyone – a Chinese medical tradition, and our access viable profession. What do we do about to that tradition. I think that without real that? access to the sources and the history of that I think we are where we are and we just tradition and to all its current practice and have to do the best we can. First, I think you debates, this claim is somewhat phoney. need to admire everyone who contributes And sooner or later it will become clear to the development of Chinese medicine to others that we are making this phoney in the modern world against all the many claim. Rather than the absence of evidence- odds stacked against this, and all the people based research, this to me this is the single who make it their life work. I think we are most important reason for why we are such sustained in that by being able to help a weak profession.

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How should someone like me go about like Yue Mei-Zhong, or Cheng Men-Xue, or learning Chinese? Zhu Liang-Chun? Of course, you can say Now? At your age? “Why should we? We have our own inspi- rational practitioners.” All I can say to that Yes, as a practitioner, say I have done is that there is a depth to Chinese medicine There is a depth to Chinese all my qualifications, and I want to as a tradition that you cannot fathom with- learn Chinese to improve my practice. out actually experiencing it. And the only medicine as a tradition that Ideally, take a few years out and go to way to experience it is to engage with it. I you cannot fathom without Taiwan or China. think that experience is largely lacking in actually experiencing it. And‘ the only way to the West. It makes our tradition shallow, ’ But people aren’t going to do that, is less alive, more boring, less effective, and experience it is to engage there an alternative? ultimately easier to uproot. with it. Well you would have to find a way. Find a I think that disciplines like anthropology teacher, get up one hour earlier every day and history can help us to understand to write your characters! It’s a discipline. It’s better what is going on. Though I think this not easy. And once you are 40 and you have may not, at first, be very comfortable for us. never learned languages, it becomes more They can help us, for instance, by taking and more difficult, which is why ideally we an outsiders’ perspective on the knowledge would do it when we are 18, and we have economy through which Chinese medicine time, and our mind is open. It’s unrealistic to is taking root in the West. From this wider expect that of 40-year-olds. But just because perspective, China is the centre and the an older generation of practitioners did not UK is just a small island at the edge of do it is no reason for the next one not to another bunch of small countries called do it either. I am therefore very encouraged Europe. Like Melanesia is for us. It’s not that in every class I teach there are always really that important. In Melanesia the one or two people who actually make the flow of knowledge from the West originally effort. So maybe slowly slowly things will got managed by what anthropologists call be changing. “big men”. “Big men” are unelected leaders and power-brokers who get to where they You spoke before about the importance are by trading in knowledge, among other of history. Could you say a bit more things. They tell the natives, “Look, you about that? don’t actually have to spend all this time I think that history, anthropology, science and effort learning Western languages or studies and other humanities’ disciplines actually go there. I can do that work for can bring another dimension not just to you. I teach you what you want to know.” research but also to our practice. They can It sounds good but, in fact, the natives only bring a deeper, a more lived understanding ever get partial access to this knowledge, of what the tradition is about. To me it is of course, and it’s always filtered through a similar to being an artist. Becoming a good distinctive lens. The “big men”, on the other artist means that you need to practice tech- hand, not only get money and power and nique. But if you are a painter in the Western status for their efforts but by definition tradition you also need to know Van Gogh they end up knowing more than those they and Picasso and Rembrandt and Dürer. In teach. It’s not a reflection on individuals’ fact, I would say you don’t need to know characters. It’s just how the system works. them. You want to know them. You want to My vision for Chinese medicine in the know them to see what others did before West is to move away from this “big men” you, to inspire you, to serve as a model, or economy of knowledge exchange to a as something you can move away from. As more democratic one in which we can practitioners of Chinese medicine we also all participate as equals. One of the most need this kind of inspiration, but here in important signs of a vibrant tradition is the West how many of us really know Ye argument. Every time something really Tian-Shi? Or Yu Chang, or Zhang Jie-Bin, creative happens, whether in quantum or Miao Xi-Yong, or any of the influential physics or Chinese medicine, it is because practitioners in China of more recent times people debate and argue with each other as

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equals. People may hate each others’ guts France via people like Soulié de Morant but if you enter into an argument with and van Nghi, while Porkert was speaking someone else you acknowledge that the of Chinese medicine in Latin. I am the kind other person’s view is as important as your of person who needs to find out things own. Our profession, as far as I can see, is for himself and so I turned to history and almost devoid of such creative argument. anthropology, initially because I hoped that Or if there is argument, it immediately this would allow me to find out which of gets personal or is mistaken for being these many views was true. Instead, they You could argue that the personal, which is not surprising because helped me to understand that trying to effectiveness of Chinese in “big men” economies all argument is by discover the “true” or “right” approach was medicine is rooted in definitionad hominem. I believe that if all of asking the wrong kind of question. Asking understanding yin and us could read Chinese, if we all had access why particular people at particular times yang‘ rather than any to all of our tradition, then we would also do what they do, what other options they ’ get more creative argument, more debate, had if they did things differently, and what specialist techniques. That and a more vibrant culture. constrains and enables change – those kind seems to be confirmed to of question are much more rewarding and me by looking at the life It’s very boring, too, that it is men. meaningful to me now. trajectory of many really I have always had an issue about The other valuable thing about history good clinicians. that because most of the students are for me is that it has made me more humble. women. You realise that almost all of the big issues Well, I am a man, so maybe I am not the that we talk about today have already been right person to answer that. Women seem talked about in the past or by others. The to be involved more in the infrastructure whole question of East versus West, of of our profession. They are teachers and Chinese medicine versus Western medicine, they constitute the majority of students for example, that is so important to us, is and practitioners. But the actual translation also a big issue in China, of course. As far process we talked about seems to be carried as I can see that debate has been carried out by men. Anthropology is useful because out at a much higher intellectual level there it helps us to understand that such things than it is here. I am particularly fascinated are not accidental or happen at random. by the 1920s and 30s when the Chinese Certain kinds of society are tied up with “science wars” were at their most extreme. certain kinds of knowledge transmission, It is also a fantastically creative period in power relationships, gender relations, the history of Chinese medicine. and so on. So if you want to change the Chinese medicine doctors in China in the relationship of power between the genders 1920s and 30s struggled hard to define their in our profession, maybe you need to find a tradition in relation to Western medicine, way of moving us away from the small-scale which was by then in the ascendancy, and tribal society that we seem to be at present I think knowing something about those and towards a more democratic and equal debates could significantly help us in our type of society. own struggles and our thinking about All this helps to explain, perhaps, why I who we are now. Take Yun Tie-Qiao, for got involved in history and anthropology instance, a sophisticated person with a very and continue to be fascinated by it. One traditional education, who also learned of the most important insights for me English, became a translator of English after I started studying Chinese medicine novels and an editor of Chinese short was that there was, in fact, no Chinese stories. Then, for personal reasons, he gets medicine in the way that I had imagined. involved in medicine, becomes a Chinese This was the early 80s. Here in the UK, you medicine doctor, and emerges as one of had the Worseley Five Element people, the the main voices in debates between radical TCM proponents, the van Buren “stems & modernisers and the “national essence” branches” people – all claiming that they people who believed there was something were representing “true” Chinese medicine. worthwhile salvaging in traditional culture. In Germany people seemed to be much I think he won the intellectual argument more eclectic. There were influences from and in the process redefined Chinese

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medicine as a “systems science” long before about yin and yang but one does not really systems thinking was invented over here. In understand it. One looks for techniques doing so, however, he also in a certain way that work because one is insecure. One disembodied Chinese medicine and this looks here and there, tries things out. But had enormous consequences for how we then in the end, one returns to the simple Some people may be happy now practise and teach it. Yun Tie-Qiao was again and that is really because one can by all accounts an accomplished clinician, now simply see yin and yang. Even if such to mould Chinese medicine and his medical texts are fascinating to an expert specialises in treating just one towards more reductionist read, yet I think that almost nobody in the condition, they treat that condition well ends in order to have a greater‘ stake in our current West even knows his name. Don’t you think because they understand very clearly the ’ that is a shame? yin and yang in that particular domain. world, but then in 30 That’s very different from specialisation years time that world itself There is another difficulty I’d like based on technique and a narrowing may have changed out to ask you about. How do we marry down of the focus of knowledge, and very of recognition and what the idea of an intervention being different especially from institutionalised seems an astute tactical standardised enough to measure it specialisation that defines specialisation as move now may turn out with our ideal case study approach? the necessary end goal of teaching, practice I think there are two issues here. The and research. to have been a disastrous first is how Chinese medicine evolved in So even though I think there is a structural error. late imperial China. A good Confucian and cultural pull towards technique and person – and all elite physicians aspired standardisation in our society, I think we to be that – was by definition a generalist should stick to the ideals implicit in the for whom medicine was just one aspect elite Chinese medical tradition. To me that of living a cultural ideal. Much like is where its effectiveness comes from. We gentlemen scientists over here in the early should be stable and firm and confident modern period. Structurally, medicine about who we are. Then, if we find there is was practised in an almost completely no niche for us in this modern world, then unregulated context, where each physician that is just too bad. It would be a shame, could pretty much do what he wanted to but it would be the choice of our culture do but also where economic competition and our society. Some people may be was extremely tough. In such a context, happy to mould Chinese medicine towards individualised practice represented by more reductionist ends in order to have a and taught through cases rather than greater stake in our current world, but then standardised interventions tends to be the in 30 years time that world itself may have norm. Therefore, I think that the current changed out of recognition and what seems push for standardisation, that is by the an astute tactical move now may turn out way not just coming from without but also to have been a disastrous error. from within our profession, has to do both About three years ago, quite by chance, I with changing contexts of practice and with was invited to a conference in Beijing on changing cultural ideals about what a good systems biology and Chinese medicine. At physician should be. that point I hadn’t heard about systems To me this raises the issue of effectiveness. biology or if I did I had paid no attention. If you think that the most important thing I flirted for a while with systems thinking that we do is harmonising yin and yang, in the 1980s but found the links with then that applies to whether we treat a child, Chinese medicine very forced at the time. a pregnant woman, or an old man. So from That conference, on the other hand, made that perspective you could argue that the me think again and re-evaluate many of effectiveness of Chinese medicine is rooted my previous prejudices, not least about in understanding yin and yang rather than biomedicine. The systems biologists talking any specialist techniques. That seems to at this conference were extremely self- be confirmed to me by looking at the life confident people, arrogant even, but also trajectory of many really good clinicians. people who for whom all this reductionism Of course I am generalising but the typical that we conventionally associate with route seems to be that one first learns biomedicine is already a thing of the past.

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For them it was clear that in the not-too- this in order to make Chinese medicine distant future they would dominate the more widely accessible. The problem is to field. Their vision is of a personalised define and match the population and the medicine based on research that will be intervention. For some conditions that able to use each individual person as their will be easier than others. That is why for own control, and they are developing the case of menopause, where there exists the methodological and technological considerable evidence for cultural variation resources to achieve just that. Interestingly, in the experience of symptoms, we are quite If, say, you had four because complex systems demand complex specific that whatever we do will only have patterns of menopausal interventions these people are interested in relevance, at least initially, for women in hot flushes, you had Chinese medicine. Not in order to rescue London. Furthermore, precisely because reliably effective it or preserve it but because Chinese of this cultural variability, we assume that treatments‘ for these, and medicine does already do poly-pharmacy. potentially effective treatment strategies ’ It is a complex intervention that provides are not necessarily available ready-made you were able to reliably diagnose them, what resources for what they want to do. So in some Chinese textbook, but that they would be wrong with maybe rather than appeasing the people need to be discovered in the course of in power today we should align ourselves actual practice here in London through a teaching those to nurses or with the people who will be in power in the process of action research. To this end, we GPs? future. have established a menopause clinic at Westminster, where a group of practitioners My understanding is that in your work treats women with menopausal hot flushes. on the menopause study you have, These practitioners regularly meet to nonetheless, developed standardised exchange ideas and experiences with a view formulas to give to certain types of to learn from each other. That is, while women? trying to define effective treatment strategies As I said before, the EASTmedicine meno­ we are also trying to create an environment pause project is a very long-term project where practitioners themselves can develop that has a number of different dimensions. their skills. This, I think, is very different It’s conceived as a model to explore the from the conventional model of simply multidisciplinary­ approach to researching evaluating a treatment. For me the definition Chinese medicine that I talked about. of patterns and treatment strategies follows That means first of all we have tried to from the development of practitioners. I understand what menopause his; how it am not interested to define treatments that affects women specifically here in London; I can then prescribe practitioners to do. I how Chinese medicine constructed its am interested in helping practitioners to interface to what is, after all, a very modern become better practitioners and with that condition; what resources are available to our tradition to grow. As I am going on, I treat menopausal symptoms in the wider can see some shortcomings in this model East Asian medical tradition; and also but exploring that would need another how and why the “big men” approach to whole conversation. the translation and trafficking of ideas reduced these many approaches to just a So the problem is actually not in the few patterns and formulas in the minds of practise of standardising formulas but most western TCM practitioners. The next in who does it, who delivers it? stage is to see whether we can treat meno­ Not even that. If, say, you had four patterns pausal symptoms, particularly hot flushes, of menopausal hot flushes, you had reliably successfully and what approaches work best effective treatments for these, and you were for that. If that means being able to come able to reliably diagnose them, what would up with a few core patterns and treatment be wrong with teaching those to nurses or strategies then so much the better. GPs? At the same time, however, it would be At the same time, I think that within any equally important to teach these nurses or group of people suffering from the same GPs to understand why some women will problem you are bound to get only so not fall into any of these categories, and that much variation and that it is OK to exploit it was appropriate to send these women to

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specialist Chinese medicine practitioners working in an that for treatment. drew me into Chinese medicine in the first place. And then a real problem here in And is this still Chinese medicine? the UK, at least, is the division that exists Why not? It is East Asian medicine. It between Chinese and Westerners practising We want it, but we is informed by East Asian thinking, by Chinese medicine, and between herbalists simultaneously also concepts like fullness and emptiness, heat and acupuncturists. I think we should take continue somehow to feel and cold, and also by the desire to make the Australia or the US as models, where this is complex simple without being reductionist not the case because of conscious political superior to it. This is an important‘ reason, I think, in the way I tried to outline that before. efforts within the profession to overcome ’ The difference is that I am thinking of East them. I think this should be a priority for why we consider learning Asian medicine as a social rather than an our professional bodies. Overcoming these Chinese to be too much individual process. My end goal would be unnecessary division would tremendously effort ... Chinese medicine practitioners to deliver enrich who we are and strengthen what we such treatment, but another goal also has to do. be to make Chinese medicine more cheaply For me as an anthropologist and historian, available – and if that means teaching it to there are also still exist real and enduring nurses of GPs for limited contexts of use issues about how the West relates itself to then I can see nothing wrong with that. “the other”’ issues that lie at the bottom There are so many goals, and we have to of much of what we have talked about. achieve them all at the same time. This ties to our imperialist past and neo- At the moment Chinese medicine is an imperialist present and explains the very elite middle class thing. Yet, medicine is ambivalent relationship we have to this surely also about helping people whoever “other”. We want it, but we simultaneously they are and that means it needs to be also continue somehow to feel superior cheap, easily deliverable, and reliably to it. This is an important reason, I think, effective. I don’t think we should surrender why we consider learning Chinese to be too this goal because of some other ideological much effort while every biomedical doctor commitment. Furthermore, we wouldn’t be in China does study English. This is another saying to this woman with hot flushes, look reason for me why learning Chinese should I’m sorting out all of your life: your hyper­ become a compulsory aspect of Chinese tension, your depression, your backache. I medical education. It would demonstrate am just helping you get relief. If you have a certain kind of respect for engaging with more complex problems then this simple this “other” on its own terms, and it would approach is not the right thing for you. But show our Chinese colleagues that we are if you are just feeling hot during this period really taking them and their medicine of transition then maybe we can help with seriously. I know from many conversations that. I have had that they would appreciate that very much. What other difficulties would you highlight about Chinese medicine in Changing direction a little, what is the West? your perspective on the blending of Well, I have already mentioned our Chinese and Western medicine? Do you tribalism, which I see as not very helpful see that as invigorating or destructive for the development of Chinese medicine. for Chinese medicine? Another problem for me is what appears In any such encounter there are different to be a gradual turning away from treating possible outcomes. Chinese medicine may disease in all its forms in favour of just a be radically transformed and to a certain few niche markets. Maybe that’s more extent that has already happened. The Ante Babic’s the case with acupuncture than herbal very definition of Chinese medicine as medicine but the focus that has developed “Chinese” already implies an opposition to Tips for running in recent years on infertility and on such the West, and many historians would say a successful clinic ... things as cosmetic acupuncture, to me that there is nothing within what we call Testimonials lack class. that is a far cry away from the ideals of TCM that is not in some way a product of

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this opposition. Certainly, much of my own enables or constrains how we communicate work has been concerned with laying bare with each other. Over the last century, the this influence. relationship between Chinese medicine and Another way we can think of Chinese Western medicine has been entangled with medicine is that it constitutes a resource, the history of Western imperialism, whose an incredibly valuable cultural resource power has skewed it in a very distinctive that intelligent people have developed over direction, some of the facets of which we thousands of years and that is therefore have talked about here. Tradition embodies the worthwhile to keep alive. Keeping it alive, But other, more equal types of relation­ living words of dead however, does not mean preserving it like ships are also possible. I particularly like people while traditionalism in a museum, but to use it and employ it a group of Chinese medicine doctors embodies the dead words for the sake of changing our lives in the known as the “current of assimilation and of the‘ living. present. convergence” who were active at the turn of ’ Jaroslav Pelikan, a famous scholar of the 20th century. They were very excited by Christian history nicely compares tradition biomedical science, but did not yet feel they with traditionalism. He says that tradition had to either kowtow before it or otherwise embodies the living words of dead people reject it. while traditionalism embodies the dead As a result they created a way to think words of the living. I think that is a very about Chinese medicine that is highly beautiful way of putting it, and links up original, that I have adopted myself as to what I previously said about debate and the foundation of how I practise, and that argument being an outward manifestation apparently owes as much to the steam of a vibrant tradition. engine as it does to the Yellow Emperor. Seen from that perspective the encounter If we can succeed to reduce the distorting between Chinese and Western medicine effects of power on the encounter between can become very stimulating and actually Chinese medicine and ourselves, whatever enriching. When I teach formulas, I always form that power takes, be it the large tell my students the story of Zhang Xi-Chun, scale forces of orientalist discourse or a famous doctor who worked in northern empire, or of the more local ‘big men’ China during the early 20th century. He economies of knowledge, then I believe analysed Western medical drugs in Chinese that this encounter could become medical ways and combined them in incredibly productive and a source of formulas such as White Tiger Plus Aspirin much innovation. Innovation that does not Decoction. Some students are horrified challenge or undermine Chinese medicine because it violates their ideas about what but that rejuvenates and develops it. That Chinese medicine is and therefore, in a will require, amongst other things, to let go certain way, their sense of identity. of all those convenient stereotypes that at But Chinese medicine is not about purity, present define Chinese medicine and to see it’s about helping people, about adjusting both Chinese medicine and biomedicine to changing times, and about being creative. as constantly changing and developing It’s also a good example that Chinese traditions fractured along all kinds of lines doctors were already thinking about what of tension. I personally, for instance, feel we call herb/drug interactions long before much more comfortable engaging with we did, and that they did so on their on open-minded doctors or evidence-based terms, in their own very creative ways – and researchers than with traditionalist Chinese that we don’t even know the half of it. medicine practitioners. I also believe that I think exciting things happen when it is the critical voice of science studies, borders get crossed, when things get mixed of anthropology, and of history that can n Reprinted from the RCHM up, when taboos are broken. The entire help us create the neutral space where this Journal, May 2010, Vol 7 No 1. history of Chinese medicine is a history of kind of creative dialogue becomes possible. such encounters and only traditionalists Sorry for belabouring that point. But you n Volker will be in Australia believe that it should be otherwise. wanted to do an interview with me and that for a series of seminars: So the problem is not mixing things up. is what I think. see Page 51. The problem is the relation of power that

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