I read The Web That Has No Weaver: Understanding Chinese Medicine last year. First, I'd like to say that eBooks have completely changed the way I read. I never used to notate or highlight because I like to keep my books in pristine condition. No problem here. I also find it easier to hold and read an eBook for long periods of time than a paper book, it's easier on the arms and neck.

The Skeptics' Guide to the Universe, my favorite podcast, frequently rails against Complimentary and Alternative Medicine (CAM) as pre-scientific and subject to all of the problems of anecdote-based practices. The absence of controlled and blinded trials leaves them open to confirmation bias, placebo effects, and data cherry-picking to hide the true nature of their efficacy. This much is non-controversial. But I wanted to understand what the real basis of Traditional Chinese Medicine (TCM) is. Amazon.com had a big sale on Kindle books, so I jumped on the opportunity to order one I otherwise wouldn't have.

TCM has three major differences from Western medicine (called biomedicine by this book):

1) Western disease frequently has a direct cause which can be isolated and treated, such as bacterial infection. TCM evaluates "patterns" of health and treats disharmonies in the body's behavior as a whole. Nothing can be isolated from the whole and remain meaningful, it loses context. According to TCM practitioners, this inability to isolate parts from the pattern makes TCM difficult to study with modern Western medical trials.

2) Western medicine has a major focus on the specifics of anatomy and the functions of the organs in the body. TCM has only a vague understanding of anatomy and isn't interested in the organs in a literal sense, they have figurative meanings and behaviors that are more important. Everything about the body and its harmonies and patterns can be understood in the context of Yin Yang balance theory.

3) Western medicine focuses on cures that treat the specific, isolated cause of the disease, such as medicine and surgery. TCM treats disharmonies in the body using herbology and acupuncture along the body's meridians. Controlled trials have thus far failed to find acupuncture useful for anything other than pain management, but many Chinese herbs may actually have active ingredients that can be extracted, purified, and packaged into controlled dosages.

The book is refreshingly honest about the failings and inadequacies of TCM, but seeks to portray it as complimentary to Western medicine. Where Western medicine is overwhelmingly superior in the areas of disease control and surgery, TCM is supposedly better at subjective effects such as quality of life management and disease prevention. It does, in its favor though, try its best to dispel some of the myths that have risen up in the West about TCM. For example, herbology is often marketed as safe and all-natural (frequently safe because it's all-natural), when in fact it is well known in the East that many herbs, like most drugs, can have side-effects and even be toxic in large doses or over long periods.

On the whole, the book did confirm most of what I'd heard about TCM, although I now have a more complete context from where I can oppose it. Much of it is little different from magic, it's shoehorned awkwardly into Yin Yang balance theory even when it obviously doesn't fit in places, and is almost entirely reliant upon the original 2,000 year old foundations being irrefutable when our understanding of how the world, and the human body, works has come so far since then. Bringing Yin and Yang into balance, for example, is portrayed as something to be done by either reducing the excessive element or increasing the deficient one, even when the Yin and Yang are not opposing forces across a neutral in that case but rather a continuum starting from a zero point. For example, while North and South magnetic poles are, indeed, opposing forces around a neutral, forces such as hot and cold and pressure and vacuum cannot be balanced by "increasing cold" or "increasing vacuum". That's nonsense since cold is merely the absence of heat and vacuum is merely the absence of pressure.

The truth behind Traditional Chinese Medicine in the modern context is that China was well on its way to adopting Western medicine until the Communist Revolution. When the Communist party took control and attempted to modernize China, they looked around and saw that they couldn't possibly provide adequate medical care for their half-billion population, and basically kept the few Western-educated doctors for themselves and left the peasants to TCM. But because it's foreign, ancient, and natural, it's gaining popularity among Westerners who think those are concepts in its favor.

The book stops short of actually teaching the reader how to diagnose and treat disorders with TCM, glossing over the basic concept of acupuncture meridians without going into detail and not getting into the specifics of herbology at all. But it's very, very well referenced (there are literally dozens of citations on every chapter), refreshingly honest, and overall an excellent reference to understand the foundations and theory behind TCM. I'd recommend it to anyone who wants to know more about TCM, either to make an informed decision as a consumer of it, or to more fully understand it to be able to argue against its value as a pre-scientific relic.

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