The Treatment of Rare Diseases in Chinese Medicine
A question from a member:
“I would be interested to know what insights you think or can find that a Classical Chinese Medicine perspective would have on so-called "Rare Diseases", for example as defined in the US and UK as those diseases with a prevalence of under 1/1500 (US) or 1/2000 (UK) people. I suppose there are three dimensions to this.
A. Whether the sheer breadth of experience of classical chinese medicine practitioners extended so far as to specifically cover some or many of the diseases considered "Rare" (and unresearched) today
B. Whether "Rare Diseases", which slip through the net of Western diagnosis because there is of lack of specialized research on each individual condition, due to their rarity– to which the Western response is "individualized medicine" in the form of genomics– would be noticed and properly treated by a high-level Chinese medicine practitioner as a matter of course, just due to his/her highly developed sensitivity and the power of the yin-yang paradigm
C. Whether (or what level of skill in) Chinese medicine can treat disease that originates from a genetic level, as "Rare Diseases" often do, at the root, that is, treating the disease directly at the genetic level
Your question is very deep and wonderful, and unfortunately I do not have a quick easy answer. My first response is that the concept of "disease" is so different in biomedicine and Chinese medicine that it feels like a case of comparing apples and oranges. So the first question I ask myself, to answer your question, is what is the equivalent in CM of a "rare disease"? And here I also have to point out that my specialty is what I, for lack of a better term, call "classical Chinese medicine" (CCM), not the contemporary version TCM being taught at a lot of institutions in China and in the US. So in TCM, many people do recognize biomedical diseases, and they would give you a very different answer from me. And a clinician will have a different perspective from myself as a medical historian. I have my head in the classics all day and see it as my role, for better or for worse, to communicate the medical paradigm expressed in the traditional medical literature so I do not interact with biomedical diseases as much as my clinical colleagues.
From my perspective, CM does not address a disease in the same way as biomedicine as a distinct entity, but a specific human body at a specific point in time, in alignment with the way in which that body, as a microcosm, is situated at that moment in the macrocosmic environment that it resonates with. Of course diseases and treatment protocols and specialized formulas or groups of formulas exist, but at the root of any clinical encounter is the assessment of the patient’s particular state of yin and yang, qi and blood, etc etc at that particular point in time, with the diagnosis of a disease more as a guidepost or a suggestion for a direction to explore for treatment. Does that make sense? See for example the way Hilary Smith has written about 腳氣 “lower leg Qi” in her book Forgotten Diseases: Illnesses Transformed in Chinese Medicine, or Angela Ki Che Leung’s book on Leprosy in China. A History . So the biomedical concept of a rare disease doesn't fit into that paradigm to begin with. Given that a CM practitioner addresses the patient in front of them, no two patients are alike, and no two diagnoses and treatments are alike. I believe this means that I would answer your question B above with a resounding YES. And I like the way you worded your question, there, by the way.
Now, regarding your question C, about the genetic level, this is a whole other can of worms, and my hope is that somebody else among the "Imperial Mentees" might jump in here with their clinical experience. Obviously genetics would fall into the category of "earlier Heaven" 先天. Regardless of the root of the disease, CCM addresses the condition right in front of you, so again, this totally depends on the condition. "Rare diseases" can mean so many different things and manifest in so many different ways, no? The true strength in this area, in my opinion, would be the multi-generational approach CCM takes and the contributions it makes to fertility and gynecology, as well as andrology, in terms of addressing these sorts of issues BEFORE conception and then during pregnancy so that babies are born with a healthier foundation to begin with. And then the idea that congenital conditions can in many cases be addressed much more easily and effectively in early childhood than if we allow them to progress into adulthood. CCM pediatrics is an area I feel strongly about and where I see a whole lot of untapped potential, especially as it is currently practiced in the West. Your question deserves a book-length answer and I know I am not doing it justice, but it’s a start.
I am afraid that this is not the answer you were looking for, but it is the best I can do just off the top of my hat. I hope there is something of value in it for you! Feel free to follow up and respond below, whether you agree or disagree. It's a great question and my answer is just my own tentative attempt to address it from my perspective. Clinicians will have a different take and different angles to contribute.