Traditional Chinese medicine (TCM) is an empirical medicine and was developed in the old days in the absence of systemic scientific knowledge. Thus, it is a product of the accumulated clinical observations gathered over centuries of practice. Its development was inductive and looks at the human body's behavior as a whole during the course of a disease. TCM defines a normal functioning person as having balance within him or herself and with the natural environment outside the body. In contrast, a diseased condition is a deviation from this balance and the role of medical treatment, according to TCM, is to restore the balanced state. Due to the subjective nature of TCM, it is a system that needs modernization before it can be applied effectively in modern healthcare.

From a systematic point of view, the TCM model is very much like a black box. The outputs (physical symptoms and signs) and inputs (pathogenic factors, herbs, diet, treatment) are observed without the details of what is happening inside the body system. Although the exact mechanisms are not presented, the black box method can be suitable for open, large, and complex systems like the human body. The inputs can be adjusted while the changes in the output can be observed with reliable results over time. These observations can then develop treatment inputs that bring the body back into balance. However, because TCM lacks detailed and concrete mechanisms, it is difficult to conduct meaningful scientific experimentation in the modern age. During diagnosis and treatment, decisions are completely individualized for each patient and the same protocol might not be repeatable for other patients. Thus, the effectiveness of TCM can heavily depend on the skill and experience of the practitioner and is not well suited for a generalized class of disease.

The Western standard of double blind, placebo controlled and randomized trials are not suited for the study of TCM. In TCM, the diagnosis of the status of health or disease in a patient is described by what is traditionally called Zhen (symptom-patterns.) The nature of Zhen is a summary of the pathogenesis of a particular person at a particular stage of a disease course. Zhen describes whether the symptoms are hot or cold, internal or external, excessive or deficient and summarizes them into patterns of Yin and Yang. Thus, Zhen is a summary of the functional status of the patient and not a description of anatomy and pathology. TCM treatment is based on using particular herbs to restore the lost balance diagnosed by the Zhen, an example being using a "cold" herb to balance a "hot" condition in the body. The vague and mystical nature of TCM makes formal experimentation and study difficult. From the modern microbiological point of view, Zhen does not differentiate between the etiological factor (the cause of the disease), which can make for inaccurate diagnosis since different diseases may show the similar types of Zhen or symptoms. Without a reliable way to determine the etiological factor, TCM treatment might not work well for the infectious diseases unless it is properly diagnosed.

The herbal formulas used in TCM treatment are also individualized and usually contain eight to twelve combinations of herbs. Each herb within the combinations can also have dozens of different active ingredients that may vary depending on the season, place of production and other factors. This makes it very hard to standardize the results of each batch and is another area that TCM needs modernization.

Despite its seemingly out-dated methods, the vast amount of accumulated information stored in TCM can provide useful applications for treating modern diseases such as Hepatitis C. The integration of TCM with modern methods is a key step towards better healthcare. The next article will discuss Modern Chinese Medicine and it's development. (Part 3)