After reading 方先生的为什么说中医不是科学 and many papers on the forum I agree and support the main ideas as many viewers here however I have some thoughts and concerns here for discussion:

1. Anyone with modern scientific training and normal logics will agree and probably reach the same conclusion as Dr. Fang eloquently displayed in his article. Is T.C.M. as a whole can be called as SCIENCE in its modern definition? ABSOLUETLY NOT. It would be an insult to the intelligence of the educated minds.

2. I respect the courage, effort and extent of professional knowledge Dr.Fang and many others in pointing out the obvious Emperor's clothes. It may not be the best catch phrase of the deep rooted T.C.M. tradition. The phenomenon is more complicated than its face value.

3. The counter-criticizers: many fervent believers either due to personal experience, personal interests (financially or politically), or lack of modern scientific education. However, I assume some main stream professionals (so far as I know of) may not TOTALLY agree the uselessness of T.C.M. as a whole or it seems on this forum due to the “biased” opinions published here. (Bias is not used as derogative here but just pointing out as a fact. A lot of formal scientific journals are biased.) I am also excluding the irrational uneducated so called professional here as I mentioned as “professionals”.

Unfortunately, the logics of many of the defenders are riddled with fallacies. Still, many are not professionals either T.C.M. or modern medicine practitioners/researchers as I have read so far. The obviously lacking of modern medical knowledge of many of the respected figures professional in T.C.M. is shocking.

Irrelevant blames and abusive languages are frequently seen on many different forums. However, some of the defenders have expressed their deep concerns for their love of the Chinese cultures with proper etiquette and expression of their ideas. (Even though scientifically incorrect in many of the expressions that I have read.)

In facto lacking of well designed RCT evidences of T.C.M. claims will remain in suspicion of the mainstream scientific society. Even though, some of the clinical observation can at least raise the interest for further investigation. However, the credibility of the studies from China may be dubious sometimes with no solid designs.

3. Several concerns here for discussion:

a.    It seems to me not as many criticizers are medical professionals. Obviously conflicts of interests are a big issue for the many T.C.M. practitioners I assume. However, the extent of the issue is larger than its face value as many can perceive. The stratification of the T.C.M. society may have diverse responses reflecting its many layers of the stratification. Conflicts and changes between conservatives and reformers are seen not only outside the profession but also inside the academics long before. There is no absolute shortage of well trained scientists in the field. At the same time, the profession has long been contaminated by many of the pure quackery in the history and today. Some may argue the profession has been a quackery since its birth however many may disagree. The historical limits and later political influence may be a more accurate depiction of this folk medicine. An unbiased third party with professional knowledge is hard to find and establish due to lacking of scientifically persuasive evidences and credible research as well as political influence. There seems no quick resolution as of now. However, as Prof. Zhang has mentioned it is good to see that topic has become openly debatable.

So far as I can see that the criticisms are more limited to the face value. The many aspects of the ridiculously practice are of the categories of “captain obvious”. The theories and terms used in the T.C.M. practice are likewise obsolete and may seem absurd. However, it some times serves as the categorical leads for the vast empirical observations. The clinical descriptions are objective and probably the best they could come up with at the time of its birth without the inputs of modern science. The details of discussion of this hypothesis are beyond this preliminary topic that I could explain. I always believe that sometimes the problem is deeper than it appears to be especially in the behold of the well trained.

b. Is this a pure professional issue? May not be so as I have felt. From this forum, it at least can be called as a movement of abolishing T.C.M. at least as a paramount of modern medicine. As many have mentioned or alluded to, the movement may not be so limited to be a technical issue. Unleashing of long suppressed thoughts of the intellectuals can be satisfied from this topic to some extent. The T.C.M. topic may be served as drainage of the psychological abscess.

I would worry if the movement has the tendency of 科学泛政治化, both sides displays either openly or inexplicitly some of the character especially when using it as a tactics of defending. (I may have simplified the debate into a bi-polar model here for the sake of making my points.) It will certainly blindfold and muffles the truth and divert a clear scientific debate into an unnecessary sidetrack.

Please avoid the movement 墙倒众人推 or just for the purpose of attracting eyeballs as being in a fashion without a sound and deeper understanding and investigation of the issue. (This statement is not personal and I am not and have no intent to allude or point out to any particular person here but just point out my concern. I would apologize here beforehand if my concern has offended any body but I believe any person with a mature independent thinking and scientific attitude would agree with me.)

I have to say that Dr. Fang’s argument is elegant and strong and he could remain his scientific attitude at the same time. I am here深感敬佩。

I have no objection on expression many personal feelings. Personal feeling is just personal feelings. Argument is just argument. Hard evidence talks when we facing clinical choices. (Of course it has to be up to the Gold standard in order to be qualified as hard evidence.)

“DO NO HARM” is the basic and humanely understandable principle in medicine. Some of the practice still used in China in T.C.M. is absurd in the point of view of main stream medicine. There is lacking of prudent practice while full of magic thinking and experimenting without research. While beneficent is another principle. If there is a thread of evidence within the vast empirical evidences that are of any clinical usefulness, there may be benefits and meanings for further investigation with modern science instead of T.C.M. theory. So far as I believe, there are more than threads of evidences still until I am convinced by hard evidence.

c. Is all T.C.M. absolutely useless? I would NOT agree AT ALL at least for the time being. Evidence medicine practice could be one of the keys to the issue. The observation and description of the diseases are objective. Many of the practice should go to the museum already with their historical value and should go to the history as it belongs to. However, some interesting phenomenon in the clinic can not be simply explained by PLACEBO (I need to back up my statement with sound papers and references. Further detailed discussion is beyond this topic here). In order to fully anatomize the underlying usefulness or mechanisms may require substantial financial and sheer man power. The question or debate is whether it is worthwhile or do we have any dispensable in the country like China with limited funds in healthcare expenditure. In United States the allocation of the research funds reflects the interest and status of the CAM (complimentary and alternative medicine category), however small but the interest still remains in the mainstream medicine. The ins and outs of the alternative practices including T.C.M. especially acupuncture are being mentioned in the formal medical school education. Reasons being that there are many patients seeks alternative therapies besides their doctors. It is good to know what they have done to your patients. Other reasons also include that there are some evidences of the usefulness of CAM practice to certain conditions though a lot limited than what is used by alternative healthcare practitioners. So in the practice, doctors could have some meaning conversation and recommendation to their patients. Some studies are currently going in major institutions. Pilot studies serves as the harbingers of further investment. That may be a model that we could emulate in the future.

4. Several thoughts:
a. Shall we absolutely casting away T.C.M practice or keep it away from main stream as many other scientifically developed nation do? Shall we and how we could incorporate some of the supplementary therapies as we unfolding its scientific usefulness in the clinical care of the patients.

b. I would suggest abolishing T.C.M. as an entry level college education but keep it as graduate level research like master degree or Ph.D. with modern scientific research after receiving degrees of modern medicine education. The current education is worrisome. The good thing is the time of pure T.C.M. practice has been long gone. But the current hybrid still does not serve its purpose. I have read 刘力红 博士 的 思考中医。I am sorry to say that it is full of magic thinking with little scientific logic to follow however I still agree strongly with his account in the social influence of the academic fields. (The discussion here is purely technically and not in person.)

I would love to hear your thoughts and instructional inputs especially Dr. Fang.

If anyone has any different view, I prefer to hear it in a non-biased and educated way.

I am here willing to accept any meaningful educational inputs as a life long learner.

I am also willing to solicit inputs from major figures like Professor 韩济生 and Professor沈自尹, Professor 曹小定whenever I have the chance to do so.

I am very interested in Dr. Fang’s article in 中药毒副作用备览

Is it possible that Dr. Fang could list the references? I would really appreciate.

I will not give up the idea of doing more research on the mechanism and efficacies of some of the T.C.M. empirical practices if possible UNLESS unequivocal evidence presented persuaded me from doing so.

Notes: The reason I wrote this in English is absolutely due to the inadequacy of my skill in typing Chinese. It really takes me much longer time to come up with a decent paper in Chinese even though my English is far from being perfect. Therefore, I used here for the time being with whatever express myself well and fast. I have lived in United States for many years and I am a professional with education in both fields of CAM in mainland and modern medicine in the U.S which is still in training. I am still reluctant in fully disclosing my credentials as of now. I believe that I am still waiting the time that I think it is appropriate and I have hopefully evolved my thoughts mature enough. Also, I have no time to handle any of the unforeseen battles online. I love China and Chinese culture but that does not affect my persistence in science, development and modernization. However longer time it may take me, I will organize and write up my thoughts in Chinese in the future and submit for publication here in this forum for viewing pleasure if Dr. Fang deems as appropriate for this site.