HKU Bulletin June 2013 (Vol. 14 No. 3)

Cover Story c W T d T e f W X [ \ e [ g h T e Q [ X [ \ R S V W X [ T U T e [ g i T U d T Q [ Z T g X f X [ T e d j k l X U f R Z m h T Z T [ d e Q n o p W X h T U d q g T [ d U X [ r T g X f X [ T s t q Q U X [ \ e [ g P W e Q Z e f n h T e Q [ e u R q d d Q e g X d X R [ e h V W X [ T U T Z T g X f X [ T e [ g X d U W q Z e [ X U d X f U m X Q X d s U d q g T [ d U X [ V W X [ T U T r T g X f X [ T h T e Q [ e u R q d Z R g T Q [ T v X g T [ f T Y u e U T g Z T g X f X [ T w x m m h X f e d X R [ R S e g v e [ f T g d T f W [ R h R \ X T U S e f X h X d e d T U d W T U d q g n R S d Q e g X d X R [ e h V W X [ T U T Z T g X f X [ T e d j k l w c W T y T m e Q d Z T [ d R S V W T Z X U d Q n q U T U W X \ W m T Q S R Q Z e [ f T h X z q X g f W Q R Z e d R \ Q e m W n o d e [ g T Z PDVV VSHFWURPHWU\ TXDGUXSROH WLPH RI ÀLJKW IRU FKHPLFDO DQDO\VLV RI &KLQHVH PHGLFLQHV e [ g g Q q \ g X U f R v T Q n w “But to truly understand Chinese medicine takes much work. The more profound and more challenging issue is the principle and theory of practice. TCM has its own glossary of terms, its own theoretical basis for deduction of diagnosis, and it arrives at different rationales on how to prescribe and take care of patients. To blend this with modern anatomy, biology and all we’ve discovered in the last few decades – that is not easy.” TCM concepts such as homeostasis (balance within the body), qi (energy flow), yin and yang, and hot and cold, are unknown in Western medicine. What’s more, the ancient texts describe things that have no modern scientific counterpart. Acupuncture points do not correspond to blood vessels or nerve pathways, and meaning attached to body parts such as the liver and kidney differ from modern anatomy. Herbal remedies, while seemingly more straightforward, number in the tens of thousands and can be enormously complex to examine even with today’s technologies. Professor Lee equated the philosophy of TCM to the pyramids of ancient Egypt. Exactly how they were built and laid out remains a mystery because “they didn’t record what they knew in a language we use today. It is almost like an archaeology of the mind to try to understand the breadth and evolution of that wisdom”. Yet the wisdom cannot be denied, said Professor Paul Tam, Li Shu-Pui Professor in Surgery, Pro-Vice-Chancellor and Vice-President (Research) at HKU who is also a paediatrician. “In Chinese medicine you treat patients, not a disease or pathology. I think that’s where it has wisdom. It aims to restore the health of the individual, although it has some way to go to prove it is effective in a scientific manner.” Improving understanding Scientific proof is not the only issue for TCM. The unknown can breed mistrust, leading some Western doctors to warn their patients off TCM as unproven, and some TCM doctors to argue their centuries-old remedies are more trustworthy than modern treatments such as surgery. HKU therefore is also trying to promote mutual understanding and enrichment by going beyond the laboratory and making an impact in education and clinical settings, too. Students in Medicine, Nursing and Pharmacy learn about TCM and its humanistic spirit and students in Chinese Medicine learn about modern evidence-based medicine. The Faculty also plans to be the first in Hong Kong to offer both Western and Chinese medicine to in-patients at its newly approved hospital, which will open in four years. Patients will be able to be treated by doctors of both traditions. “People say to me, this must be difficult. And I say, yes – that’s why we are doing it first! There has to be a pioneer. This is a good thing for the patient. If your passion is to make patients feel better, then you would use all the knowledge and wisdom available to help them,” Professor Lee said. Moving closer together The goal of merging the two traditions may be getting a little easier because they are inching closer together. As more TCM is tested and analysed with modern technologies, modern scientists are starting to appreciate its merits, particularly as a complementary adjunct to Western medicine. Philosophically, Western medicine is moving towards the more personalised approach that is at the heart of TCM, through such things as gene sequencing. “There is a saying that a good doctor treats your symptoms but the best doctor takes care of your health before you get sick. That is the principle of Chinese medicine. The emphasis is on prevention and this is what modern medicine is coming to recognise,” Professor Lee said. “I think the next frontier in the evolution of medicine will be the modernisation of Chinese medicine. The rediscovery and the re- examination of our past will yield a wonderful outcome for our future.” With a foot in both worlds, the University is best placed to forge this integrated medicine of East and West and promote the best treatment for patients. M Yields from science “TCM is like a gold mine that we can explore with our current scientific methods. These are very exciting times,” said Professor Lee Sum-ping, summing up the enthusiasm felt by both medical and scientific researchers on campus. Professor Che Chi-ming, began looking at Chinese medicine a decade ago when he led an Area of Excellence project on drug development that ultimately resulted in the discovery of a new class of saponin compounds. He and his colleagues in Chemistry, such as Morningside Professor in Chemical Biology, Professor Dan Yang, and Professor Pauline Chiu, are continuing to apply chemistry to Chinese medicine to develop new drugs, analyse herbs to ascertain their authenticity and safety, and investigate their chemical biology to understand their mechanisms of action. They are also working closely with the Faculty of Medicine to translate discoveries to patients. “In interdisciplinary research, you need the strong and the strong to come together if you want to succeed. The Medical Faculty is good at animal models and clinical trials, and Chemistry is strong in basic In Chinese medicine you treat patients, not a disease or pathology. I think that’s where it has wisdom. A B C D E F F C B A { I | } { J c W T ~ f W R R h R S V W X [ T U T r T g X f X [ T q U T U d W T d T f W [ X z q T R S e d R Z X f e u U R Q m d X R [ U m T f d Q R U f R m n d R f R [ g q f d T  m T Q X Z T [ d U R [ z q e [ d X d e d X v T g T d T Q Z X [ e d X R [ R S W T e v n PHWDOV DUVHQLF FDGPLXP OHDG DQG PHUFXU\ FRQWDLQHG LQ SURSULHWDU\ &KLQHVH Z T g X f X [ T U w c W T r R h T f q h e Q V W X [ T U T r T g X f X [ T € e u R Q e d R Q n e g R m d U e Z R g T Q [ m W e Q Z e f R h R \ X f e h e m m Q R e f W d R g T v X U T [ T p g Q q \ U S Q R Z V W X [ T U T Z T g X f X [ T w c W T e u R v T m W R d R U W R p U S Q e f d X R [ U R S W T Q u e h T  d Q e f d X [ d W T h e u R Q e d R Q n w research, particularly at the molecular level. Bringing this complementary and diverse expertise together is the way to go in Chinese medicine research,” Professor Che said. Meanwhile, the Molecular Chinese Medicine Laboratory in the Faculty of Medicine is using a modern pharmacological approach to devise new drugs from Chinese medicine, including two formulations for which clinical trials are being planned. The School of Chinese Medicine is also active in studying TCM treatments, as are other departments in the Faculty such as Psychiatry, which has studied acupuncture to treat insomnia. The School of Biological Sciences has, among other things, tested the TCM theory of ‘hot and cold constitutions’ of patients through genetic profiling, and identified a pathway involved in energy and heat production. Dr Jennifer Wan, who conducted the study, said “recent technology allows us to identify patterns and syndromes of TCM in a scientific way. However, to better understand the fundamental principles of TCM, it is important to apply its theories to our research. We can use Western scientific tools, but we should follow TCM principles when designing experiments,” she said. 09 The University of Hong Kong Bulletin June 2013