ARTICLE

International Journal of Integrative Medicine

Integrative Medicine:
A Paradigm Shift in Clinical Practice
Review Article

Weidong Pan1 and Hua Zhou2,*

1 Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai, China
2 Department of Cardiology,Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai, China
* Corresponding author E-mail: huazhoum@gmail.com
Received 7 Nov 2012; Accepted 10 Jun 2013
2013 Pan and Zhou; licensee InTech. This is an open access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract Various approaches to the care of patients coexist

in modern society, such as original traditional medicine
(including traditional Chinese medicine TCM), modern
traditional medicine, Western medicine, and integrative
medicine. Given advances in medical science and clinical
practice in the 21st century, there is a need for better
integration of these approaches. The purpose of this paper
is to summarize existing approaches focusing on original
traditional medicine, modern traditional medicine, and
Western medicine, and to propose a more synthesized
perspective that embraces various approaches under the
concept of integrated medicine.
Keywords Original Traditional Medicine, Modernization,
Modern Traditional Medicine, Western Medicine,
Integrate, Integrative Medicine

1. Introduction
There exist various healing and treatment approaches in
modern medicine, which generally fall into four broad
categories: (1) original traditional medicine, (2) modern
traditional medicine (modernization of traditional
medicine), (3) Western medicine, and (4) integrative
medicine. These approaches differ significantly in their
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origin, philosophy and treatment methodologies, and

each has its own unique health care practices. However,
the merit of each is debatable and little is known about
the comparative effectiveness of these approaches in
treating various acute and chronic diseases. In what
follows, a brief description of each approach is provided
along with a discussion of its strengths and weaknesses in
advancing medical sciences and clinical practice. The
paper concludes with a recommendation for a more
integrated approach.
2. Original traditional medicine
Original traditional medicine has distinctive advantages
and has different systems of theory that nevertheless
seem complementary. This kind of medicine includes
health practices, approaches, knowledge and beliefs
incorporating plant, animal and mineral-based medicines,
spiritual therapies, manual techniques and exercises,
applied individually or in combination to treat, diagnose
and prevent illnesses or maintain well-being [1]. The most
well-known kind of original traditional medicine is
traditional Chinese medicine (TCM). China has a longer
history than most other countries, and therefore has a
richer history of medicine history that dates back many
hundreds of years to the imperial era, when there was a

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unique system of care for diagnosing and curing illnesses.

Holistic treatment administration is the most important
and aspect of TCM. East Asians, Europeans and
Americans have been treated by TCM for a variety of
diseases with herbs, acupuncture, Tai Chi quan, and
massage. In America, Tai Chi quan has been used in
treating Parkinsons disease, fibromyalgia and rheumatic
diseases [2-4], with only rare instances of side effects.
There are also other original traditional medicines. In
Africa, up to 80% of the population relies on herbal
concoctions for their primary health care needs[5]. The
Kagera region of northwestern Tanzania has a rich
culture of original traditional medicine use and practice
[6]. Ayurveda, one well-known Indian approach, as well
as some other traditional medicine systems have
attempted to meet demand by seeking alternatives for the
conventional herbs or other ingredients [7-8], integrating
Western medicine disciplines with the tenets of Eastern
medicine. In the United States, Eastern medicine, or
Chinese medicine, is often regarded as a complementary
and alternative medicine; in China, however, it is
believed to be just as effective as Western medicine [9].
Chinese medicine emphasizes the bodys innate ability to
heal itself. Much like osteopathic medicine, physicians
trained in TCM emphasize that a pathologic lesion in one
region of the body can manifest itself in another part of
the body, such as the tongue or the radial pulse. For
example, all inpatients and outpatients who are seen on
the oncology service in the ChinaJapan Friendship
Hospital are asked to stick out their tongue for inspection
by a physician. According to the beliefs of TCM, its
practitioners can see how efficiently and properly the
body is working based on the colour and texture of the
patients tongue [9]. TCM is not simply treatment with
drugs, but also involves complicated theories and
specialized methods. For example, in Western medicine
the ears are not considered to be related to the kidneys,
while in TCM theory they are thought to be peripheral
organs of the kidneys. If somebody has epicophosis or
tinnitus, this indicates weak kidneys (Yin or Yang
deficiency) according to the theory of Chinese medicine,
and if the patient is treated with properly selected
traditional Chinese kidney medicine, the ear syndrome
might be cured [10]. The mechanism has been certified by
Shen using modern bio-technological equipment [10],
although Western medical scientists find it difficult to
accept the findings.
Original traditional medicine, such as TCM, has many
benefits as the primary form of health care in many
countries, but it has its limits. First, most original
traditional medicine theories originate in a long native
history, and have a unique system and abundant
preventative and therapeutic methods [11,12]. Some old
traditional methods such as feeling the pulse are
among the most difficult diagnostic methods in TCM, and
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may be a source of confusion for many doctors. It is very

difficult to quantitatively and objectively learn and
master these techniques. Second, the formulations of
TCM drugs are very old and inconvenient, since most
oral original traditional medicines are ingested as tisane
or boiled medicines; furthermore, there are many
different and complex ingredients in the formulations,
prepared using many different types of methods.
Improper preparation can result in concoctions with
unstable or uncertain effects, and in the worst-case
scenario the formulation prepared may even be toxic [13].
Third, some TCM uses methods that are very complex to
control, such as acupuncture, yoga, Qi Gong, Tai Chi
quan, and massage, and thus yields different effects with
different practitioners. Fourth, it is weak or relatively
slow in treating acute diseases or modern Western
diseases, such as acute heart failure, acute appendicitis,
pulmonary tuberculosis, and high blood pressure; it can
also have limited success in controlling the symptoms of
epilepsy, pain, schizophrenia, idiopathic Parkinsons
disease and so on. Fifth, some processed traditional
medicines or Chinese patent drugs, such as zinnober
poria cocos, zinnober polygala tenuifolia, and Zhi Bao
pills for children include zinnober, arsenic trioxide,
realgar and other components that can be considered
somewhat toxic; these components can therefore have
harmful effects if not used properly. Finally, ayurveda,
TCM and other systems of traditional medicine have been
facing the problem of diminishing availability of genuine
raw materials, specifically plants, animal parts, and
minerals, for several decades. There are also ethical
problems with respect to the use of animal bones or
organs and insects.
While original traditional medicine offers a popular and
effective treatment and prevention option, integration of
this traditional therapy with other contemporary
medicine approaches would further strengthen both its
therapeutic value and clinical merit.
3. Modern traditional medicine
Original traditional medicine has limitations and needs
to advance using modern technology [14]. The
modernization of traditional medicine (modern
traditional medicine) should include removing dross,
retaining essence and becoming more suitable and
scientific. Clearer theories and more convenient methods
should be developed for traditional medicine, and new
effects for old and potent medicines should be identified.
Modern traditional medicine includes four main
developments. First, the diagnosis of diseases in old
theories has been expanded. The identification of diseases
by traditional theory seems limited for modern society:
every year, many new diseases appear; some of these can
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be diagnosed with old theories of traditional medicine,

but many of them might have completely unknown
hundreds of years ago. Many modern authors have
sought to expand the diagnoses and the definitions of
traditional medicine to deal with the various new
diseases [1,14]. Second, the manufacturing processes for
modern traditional medicines have not yet been
perfected. The specificity and quality of original
traditional medicines are serious problems in many
countries. Nowadays, quality control in factories that
manufacture materials for original traditional medicine
takes place according to strict national or international
criteria. In most East Asian countries, decocting
medicines are a common form of original traditional
medicines, with others being granules, honeyed pills, and
skins of animals and outer layers of plants. Many
countries make more stable, pure components or
medications that are easy to ingest from raw materials,
even administering them as intravenous drip
formulations [14], or develop more facilitated and
organized theories of the original traditional medicine for
the use of acupuncture, Tai Chi quan, massage and other
traditional exercises or treatments. Third, the teaching of
original traditional medicine has developed and been
improved [15]. With the development of medical science
technology around the world, teaching materials and
theories for original traditional medicine need to be
developed that are in accordance with modern science. In
China, students who want to be a traditional doctor or
integrative doctor must study modern medicine just like
students who are studying Western medicine. The fourth
and final development is the advanced application of
original traditional medicine. Some doctors have used
acupuncture anaesthesia in operations [16], or use
materials from modern traditional medicine to execute
operations [17]. Modern acupuncture seems to be more
effective and powerful for treating acute diseases than the
original traditional medicine, and is without serious side
effects. Some operations that are conducted under
acupuncture anaesthesia can be as successful as those
performed using traditional drug anaesthesia.
Although modern traditional medicine has developed
rapidly, it still has limitations. For example,
pharmaceutical technology derived from modern medical
science is not suitable for modern traditional medicine
because pure oral decoctions cannot be made, even less
infusion-reaction intravenous drips. Acupuncture
anaesthesia alone is not sufficiently potent or effective for
operations [16]. There are also resource and ethical issues
related to materials used in modern traditional medicine,
such as the use of rare and endangered species of plants
or animals, and even rare minerals. The materials and
methods of modern traditional medicine developed from
original traditional medicine are often not powerful
enough to treat acute infections, high blood pressure,
epilepsy, tuberculosis, acute haemorrhage, and many
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other conditions and diseases. Traditional drug

anaesthesia can only be used in small and low-risk
operations [17]. Modern traditional medicine is unable to
treat most diseases properly without the simultaneous
involvement of Western medicine.
4. Western medicine
Western medicine is also called modern medicine. Since
the 18th century, with the developments of anatomy,
biology, pathology, microscopy, pharmacology and
laboratory animal science, most of our understanding of
diseases in Western medicine has been supported by
evidence-based research. These scientific technologies
have helped us understand, appreciate, and identify
many diseases, and have assisted medical scientists with
the discovery of details about the biology, pathology, and
pharmacology of these diseases, which include various
kinds of viral, bacterial and tuberculosis infections. They
have aided the discovery of more powerful chemical
treatments and established appropriate, low-risk surgical
procedures to cure many dangerous diseases such as
acute appendicitis, acute cholelith disease, and acute
cerebral injury, which could not be treated properly using
original or modern traditional medicines. Such
technologies enable effective methods for dealing with
influenza, pneumonia, myocardial infarction, cerebral
infarction, neuro-infectious diseases, shock, epilepsy,
cancer, and even degenerative diseases such as
Parkinsons disease and Alzheimers disease. Many
guidelines have been developed for treating sub-divided
diseases through clinical trials or good clinical practice
(GCP). The most famous and powerful contribution of
Western medicine is vaccines, which enable most people
to avoid contracting many dangerous diseases in the first
place.
Diagnoses in Western medicine are supported by
advanced medical devices and laboratory tests that
provide accurate and reliable evidence to guide doctors in
the treatment of diseases. Doctors examine patients
comprehensively and systematically with the help of their
senses (visual examination, palpation, percussion,
auscultation and olfactory examination) and hand-held
instruments such as stethoscopes, percussion hammers,
sphygmomanometers, and thermometers, as well as
advanced and accurate high-tech instruments, devices,
and methods such as sphygmomanometers, molecular
biology, bacteria culture, animal experiments, computed
tomography (CT), and magnetic resonance imaging
(MRI). They are also able to identify the real causes
(aetiology) of diseases, such as a bacterial or viral
infection, anaemia, parasite, cancer, etc. They place much
emphasis on so-called evidence-based medicine, which
has many interpretations. With advances in brain
imaging and medical technologies, PET and/or MRI scans
are increasingly being used for diagnostic purposes, and

Weidong Pan and Hua Zhou: Integrative Medicine: A Paradigm Shift in Clinical Practice

deep brain stimulation (DBS) is also becoming

technologically sound for treating the symptoms of
Parkinsons disease.
While Western medicine can be considered the
mainstream of modern medicine, it also has various
disadvantages. First, it is over-dependent on evidence. A
Western medicine physician often likes to identify the
causes of any uncomfortable feeling and to deal with it
according to guidelines published by Western medical
societies or government-related health organizations. In
fact, symptoms such as numbness, itchiness, dizziness,
and even pain cannot be completely explained by
Western medicine. The pathologies of these symptoms
are very complex; the same symptoms can appear as a
consequence of different diseases, or even without the
presence of a disease. Many diseases cannot be explained
completely using modern scientific technology, for
example Creutzfeldt-Jakob disease, amyotrophic lateral
sclerosis (ALS), acquired immune deficiency syndrome
(AIDS), cancer, and Alzheimers disease, and although
some of these have been studied based on gene
sequences, Western medicine has only weak integrated
methods for their treatment. Second, although thanks to
stronger and more effective pharmaceuticals Western
medicine appears to be effective at controlling many
symptoms of diseases, such as the rigidity and tremors of
Parkinsons disease, the pain of post-therapeutic
neuralgia, and the twitching and cramping of epilepsy, it
also appears to have a weak ability to control all
syndromes (holistic syndrome). Non-motor symptoms of
Parkinsons disease have received much attention from
neurologists, but Western medicine appears to be less
effective at controlling non-motor than motor symptoms
[18]. Western medicine is also weak in treating chronic
liver disease, the toxic side effects of pharmaceuticals,
and preventing the onset of newly developed strains of
influenza. Third, Western medicine treats some diseases
on the basis of indicators such as blood pressure, blood
cholesterolaemia, routine blood tests, and even blood
glucose,
and
treats
these
abnormalities
with
pharmaceuticals. However, sometimes the accompanying
dizziness and/or headache is not alleviated even though
hypertension is reduced; if cholesterolaemia is modified
to a normal level, the subject may appear to be very weak
or have no energy the subject may be very weak or
fatigued if their blood pressure is brought to a normal
level, despite feeling comfortable with a high blood
glucose level. It is therefore possible to say that modern
Western medicine treats patients in a manner that is overdependent on various indicators or parameters in a
dogmatic and mechanical fashion. Fourth, most Western
medicines are chemicals, and therefore can generate
strong side effects. With the development of modern
technology, Western medicine is tending towards being
perfect in physiology and pathology. However, despite
advanced
technology,
diagnosis
often
remains
4

Int. j. integr. med., 2013, Vol. 1, 21:2013

problematic, and treatment methods of Western medicine

remain non-comprehensive. Fifth, Western medicine
lacks holistic integration and individualization. Often a
disease is treated using a single method according to the
guidelines, and doctors do not consider the possibility of
differences in susceptibility among different groups. For
example, for some conditions such as high blood
pressure, different races (Asians, blacks, whites) have
different susceptibilities. Even among people of the same
race, there are differences between people who are
overweight, sedentary, heavy smokers, heavy drinkers,
vegetarians, or night-shift workers. However, they will all
be treated using antihypertensive medications according
to the relevant guidelines. They will experience different
effects and side effects. Optimal treatments and methods
based on holistic properties are needed to modify and
finalize the treatment administration.
5. Integrative medicine
Original traditional medicine, modern traditional
medicine and Western medicine both have their
limitations. In this pluralistic world, various political
systems, diverse cultures and different social values are
often in conflict. Social progress is achieved by
concurrently allowing both independent development
and integration of various perspectives, thereby
leveraging the advantages of a development system [19].
In the field of science and technology, interdisciplinary
development has become an important force for progress.
These days, at least in the United States, everyone is
talking about quality rather than quantity of care;
attempts are being made to create a large, holistic system
based on health care quality.
As an emerging medical interdisciplinary subject,
integrative medicine absorbs and integrates the respective
characteristics and advantages of original traditional
medicine, modern traditional medicine, and Western
medicine through comparison, analysis, research, and
application. This integration embodies the objective of
providing better medical care in terms of scientific
thinking, theoretical systems, diagnostic tools, and
treatment technology.
Neurology patients frequently ask their physicians about
complementary and alternative medicine (CAM) as
options for treatment. According to a 2002 survey, 62% of
people in the United States used CAM [20]. Mind-body
therapies focus on the relationships between brain, mind,
body, and behaviour, and their effect on health and
disease. Many of the techniques are associated with
relaxation and thus may be helpful for disorders where
psychological stress is a factor. Mind-body approaches
encompass a large group of therapies such as hypnosis,
meditation, yoga, biofeedback, Tai Chi quan, and visual
imagery. Integrative medicine is a means of combining any
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effective methods or treatments from original traditional and

modern traditional medicines or Western medicine, in order to
establish new, complex ways to effectively treat, diagnose or
research various complex diseases or symptoms, avoid
misdiagnoses, side effects or unilateral treatment, improve
quality of life, and prolong lives. Effective examples are the
integrated treatments for chronic liver disease [21], the
prevention and cure of severe acute respiratory
syndromes (SARS) [22], various cancers, and even
neurodegenerative diseases such as Parkinsons disease
[23-24] and amyotrophic lateral sclerosis [25].
Acupuncture has been widely studied in the United
States and in fact many insurance companies and health
care planners provide coverage for acupuncture to their
patients. There is also emerging research on the
prevention of bone loss and other chronic conditions by
Chinese herbs, if administered in combination with
modern treatments as integrative medicine [26]. Other
famous examples of integrative use are Qinghaosu
(Artemisinin) and Pishuang (Arsenic) [27-28], which have
contributed significantly to human health. Integrative
medicine could be used in optimized and holistic
treatments for any disease or symptom.
Many people mistakenly use the term integrative
medicine interchangeably with the terms complementary
medicine and alternative medicine, or collectively as
complementary and alternative medicine (CAM). While
integrative medicine is not synonymous with CAM, CAM
therapies do make up an important part of the integrative
medicine model. Integrative medicine should focus on the
whole person (holistic) and make use of all appropriate
therapeutic approaches, health care professionals, and
disciplines to achieve optimal health and healing [29]. It
combines conventional medical treatments with other
therapies that are carefully selected and shown to be
effective and safe. Its goal is to unite the best that
conventional medicine has to offer with other healing
systems and therapies derived from cultures and ideas
both old and new. Topics of interest include, but are not
limited to, the following: multiple clinical evaluative
technology, integrative biochemistry research technology
for medical applications, discovery of complementary and
alternative treatments, natural health science, composite
medical research technologies, development of biochemical
science, evidence-based research of traditional medicine,
integrative development of image methods for medicine,
development of electrical equipment for medicine, frontier
discoveries in bioscience, complex health care, hybrid
technologies for medicine, natural production technology,
and the bio-mechanisms of acupuncture or acupoint.
Whenever possible, integrative medicine favours the use of
low-tech, low-cost interventions. Through cooperative and
collaborative
efforts
of
intuitively
adept
and
technologically adept minds we can integrate and advance
our understanding, increase our ability to predict, prevent,
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and diagnose disease, and expand our therapeutic options

[30]
6. Conclusion
TCM is a leading ambassador for the various types of
original
traditional
medicine
worldwide.
The
modernization of TCM has resulted in improved
diagnoses and manufacturing, optimized concepts, and
developed measurements. Western medicine embodies
the spirit of inclusive development of different cultures.
Integrative medicine, as a whole medical concept with the
ethos of a new medicine for a new life [19], will,
through joint efforts, be able to make greater
contributions to boosting medical advances and
safeguarding human health.
7. Acknowledgments
This study was sponsored by the National High
Technology Research and Development Programme of
China (863 Programme: Hua Zhou, 2010AA0221396001),
the Ministry of Health for Major Infectious Diseases of
China (Hua Zhou, 2012ZX10004301-604), the Special
Fund of National Traditional Chinese Medicine (The
promotion of base for standard research of traditional
Chinese medicine: Hua Zhou, ZYYS-2010) and the
Shanghai Pujiang Programme of the Science and
Technology Commission of Shanghai Municipality
(Weidong Pan, 09PJ1409300).
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