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Epistemological issues in the theory of Chinese medicine

Hong, Hai (2012) Epistemological issues in the theory of Chinese medicine. PhD thesis, London School of Economics and Political Science.

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Traditional Chinese Medicine (TCM) has been criticized for being unscientific because the theory on which it is based involves entities like qi and ’meridians’ that appear ambiguous and because the internal ‘organs’ like the kidney and the spleen are very different from those of modern anatomy and physiology. Even more so, TCM methods of therapy based on the yin-yang principle, the model of the five elements, and the classification of illnesses according to standard constellations of symptoms (TCM “syndromes”) are largely unproven by the protocols of modern evidence-based medicine. This dissertation attempts to reconstruct TCM theory by: (a) providing explanations of TCM entities as abstractions and constructs that relate to observable body functions and illness symptoms and (b) interpreting TCM theory as comprising heuristic models that were constructed from clinical experience to fit empirical observations of illnesses and their treatments with herbal medications and acupuncture. It suggests that scientists should be less concerned with the ontological status of TCM entities and the epistemic credentials of TCM models than with the ability of these concepts and models to guide physicians in therapy. More importantly, it makes the argument that these models are testable using the methods of evidence-based medicine. There are methodological difficulties associated with randomized controlled trials partly because TCM treatments tend to be individualized and syndromes are dynamic in nature; observational trials may be more appropriate in some situations. It is also possible that, for patients who are more culturally attuned to TCM, the placebo effect is strongly at play and may render the real effects of TCM treatments harder to tease out in clinical trials. The dissertation concludes that the main postulates of TCM should be put to rigorous test. The result may be a leaner but more robust theory, with parts that do not stand up to the test being rejected or modified, and a possible acceptance of its more modest therapeutic claims for a limited range of pathological conditions like pain and chronic illnesses.

Item Type: Thesis (PhD)
Additional Information: © 2012 Hai Hong
Uncontrolled Keywords: Chinese medicine, evidence-based medicine
Library of Congress subject classification: B Philosophy. Psychology. Religion > B Philosophy (General)
R Medicine > R Medicine (General)
Sets: Departments > Philosophy, Logic and Scientific Method
Supervisor: Worrall, John

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