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The relationship between Traditional Korean Medicine (TKM) and modern science illustrates a clash between two fundamentally different paradigms of understanding the world, extending beyond the mere efficacy of treatments. TKM is rooted in a system that explains life phenomena through the concept of Qi (氣), a vital force, employing a holistic perspective and focusing on functional relationships.1 In contrast, modern science, based on materialism and reductionism, seeks to identify the structural and anatomical substance for every function. This report aims to explore the deep "epistemological gap" between these two paradigms.
At the heart of this conflict lie the concepts of 'Qi (氣)' and 'Meridians (經絡)'. In TKM, Qi and meridians are the foundation for explaining the physiology and pathology of the human body 3, but from the perspective of modern science, they are considered "unproven theories".5 Therefore, these concepts serve as a perfect case study for analyzing the differences between the two knowledge systems.
This report will use the 'undiscovered element hypothesis' of modern science not as a literal explanation for Qi and meridians, but as a heuristic analogy.6 This analogy shifts the simple question of "Does Qi exist?" to a more sophisticated one: "What epistemological status do entities that are theoretically useful but empirically unobserved hold? How do different knowledge systems approach such entities?" This approach provides a crucial context for understanding the historical and social power dynamics in which Western science has positioned itself as the sole arbiter of truth, leading to long-standing debates over the legitimacy of TKM.8
Table 1: Epistemological Comparison of TKM and Modern Western Medicine
| Category | Traditional Korean Medicine (TKM) | Modern Western Medicine |
|---|---|---|
| Fundamental Ontology | Vitalism/Functionalism | Materialism/Structuralism |
| Diagnostic Methods | Holistic Pattern Recognition (e.g., pulse, tongue diagnosis) | Localized, Analytical Tests (e.g., blood tests, imaging) |
| Etiology | Imbalance, Blockage (e.g., Qi deficiency, Qi stagnation) | Specific Pathogens (e.g., germs, genetic defects) |
| Standard of Proof | Clinical Efficacy, Empirical Tradition | Randomized Controlled Trials (RCTs), Mechanistic Proof |
Understanding the core concepts of TKM within its own paradigm is essential before discussing scientific verification. TKM perceives the human body by focusing on invisible functions and flows rather than visible structures.
Qi is a complex concept that cannot be simply translated as 'energy.' It is understood as the fundamental "vital force" or "vital dynamism" that enables all physiological processes.1 Disease is believed to arise from abnormalities in the state of Qi, with 'Qi deficiency (氣虛),' a weakening of Qi itself, and 'Qi disharmony (氣機失調),' a disruption of Qi's flow and balance, being representative pathological states.4 Furthermore, the balance between Qi and Blood (血) is considered essential for sustaining life.3 The theory of Yin and Yang (陰陽) serves as a framework to describe the two fundamental aspects or states of Qi, and their dynamic balance is seen as the key to health.4
The meridian system is not described as a collection of physical tubes but as a network of channels through which Qi flows. This network connects the exterior and interior of the body and organically integrates various organ (臟腑) systems.10 Acupoints (經穴) are specific points located on these meridians, serving as nodes where one can access and influence the flow of Qi.10 It is particularly important to note that acupoints are not anatomically distinct structures but rather functional locations defined by the effects that appear when a specific area is stimulated.11
This conceptual framework clearly shows that TKM has a worldview that prioritizes function over structure. Whereas modern anatomy first discovers a structure like the heart and then identifies its function of pumping blood, TKM observes a functional connection between a specific point on the foot and the eye (e.g., a clinical effect) and posits a functional pathway called a meridian to explain it. In TKM, function is the primary reality, and structure can be secondary or sometimes metaphorical. This ontological difference provides a crucial clue as to why modern science struggles to find the physical substance of meridians and why such a search might itself be a category error.
TKM therapies such as acupuncture, moxibustion, and herbal medicine are interventions designed to correct the flow and balance of Qi within the meridian system.4 The core of TKM diagnosis, 'Pattern Identification (辨證),' is not simply about diagnosing a disease name but about comprehensively assessing the patient's tongue, complexion, and pulse to identify their unique constitutional pattern of imbalance.13 This demonstrates TKM's individualized and holistic approach, which aims to treat the 'person with the disease' rather than the disease itself.
For the past several decades, the scientific community has made relentless efforts to find physical, measurable evidence for the TKM concepts of Qi and meridians. These studies span various fields, including neuroscience, biochemistry, and anatomy, and their results are both intriguing and controversial.
One of the early significant studies used functional magnetic resonance imaging (fMRI). These studies showed that stimulating acupoints on the foot related to vision (e.g., BL67 on the Bladder meridian) activated the visual cortex of the brain.14 This suggests a neurophysiological connection between acupoint stimulation and specific brain regions, but it does not directly prove the existence of an independent 'channel' called a meridian.
More recently, studies using special dyes (Evans blue) in animal models have gained attention. When disease states like colitis were induced, 'sensitized points' appeared on the skin along traditional meridian pathways, and these points showed a high correlation of about 70-75% with the locations of actual acupoints. These findings were published in the international journal 'Scientific Reports'.15 This is a significant attempt to provide visual and biological evidence for the existence of acupoints.
The most controversially proposed anatomical entity for meridians is the 'Primo Vascular System (PVS).' First claimed in the 1960s by North Korean scientist Dr. Bong-Han Kim and also known as the 'Bonghan system,' this system was proposed as a 'third circulatory system' distinct from the vascular and lymphatic systems.17 Some researchers claim that PVS is the substance of meridians, through which stem cell-like substances called 'primo-microcells (sanals)' travel 20, and that it could even be a pathway for cancer metastasis.18 However, PVS research failed to be replicated for a long time after its initial discovery. Although it has been revived recently by some South Korean researchers, its existence and reproducibility remain subjects of scientific controversy and legal challenges, and it has not yet reached academic consensus.17
Some physicists are attempting to translate the abstract concepts of TKM into the language of modern physics. A representative hypothesis, proposed by Professor Kwang-Sup Soh and others, describes 'Qi' as 'biophotons,' particles of light emitted from DNA within the PVS.23 According to this hypothesis, meridians act as an 'optical communication network' in our body, an attempt to reduce the concept of vital force to a material phenomenon.
While these scientific verification efforts have led to important discoveries, they are also prone to interpretative pitfalls. The phenomena observed in fMRI studies or Evans blue staining studies are clearly real biological correlations. However, these correlations do not necessarily lead to a causal proof of the meridian theory. For example, the phenomenon of a specific point stimulation activating a specific brain area can be sufficiently explained by the complex network of the known nervous system (e.g., reflexes through spinal segments) without needing an unknown system like meridians.24 In other words, scientific studies have confirmed that an 'effect' exists, but they have not proven that the mechanism causing that effect must be the traditional explanation of TKM (the flow of Qi). The data confirms the phenomenon but does not confirm the theory, trapping it in a dilemma.
Table 2: Summary of Key Scientific Investigations into the Meridian System
| Research Area | Key Findings and Claims | Main Criticisms and Limitations | References |
|---|---|---|---|
| fMRI Brain Imaging | Stimulation of specific acupoints activates corresponding cortical areas of the brain. | Insufficient comparison with non-acupoint stimulation; could be a general response of the nervous system. | 14 |
| Evans Blue Visualization | In diseased animal models, sensitized points appear along meridian pathways with high correspondence to acupoints. | Limitations of animal models; need for verification of universality and reproducibility of the phenomenon. | 15 |
| Primo Vascular System (PVS) | A third circulatory system, distinct from vascular/lymphatic systems, is claimed to be the anatomical substance of meridians. | Reproducibility controversy, lack of verification by the mainstream scientific community, absence of academic consensus. | 17 |
| Biophoton Hypothesis | Qi is biophotons (light) flowing through the PVS, and meridians are an optical communication network. | Highly speculative hypothesis, lack of direct experimental evidence. | 23 |
When the focus shifts from the search for the physical substance of meridians to the verification of the clinical efficacy of treatments, the issue becomes even more complex. Here, the core of the debate is not 'Is acupuncture effective?' but 'How do we prove and interpret that effect?'
In modern medicine, the gold standard for verifying the efficacy of a treatment is the Randomized Controlled Trial (RCT). Thousands of RCTs have been conducted on acupuncture, but the results are mixed.5 A significant finding is that while acupuncture often shows superior effects compared to a 'no-treatment group,' it frequently fails to show a statistically significant difference when compared to 'sham acupuncture'.5 Sham acupuncture is performed using retractable needles that do not pierce the skin or by needling non-acupoint locations.
These results raise the enormous question of the 'placebo effect.' Research by Professor Ted Kaptchuk of Harvard Medical School illustrates the complexity of this issue.5 His study found that asthma patients who received sham acupuncture felt their breathing had improved just as much as patients who received an actual bronchodilator, but their objective lung function indicators showed no improvement at all. This suggests that a significant portion of acupuncture's effect may derive from the therapeutic ritual itself (the ceremony, expectation, touch, etc.). For this reason, prestigious scientific journals like Nature have criticized TKM as being "based on unproven theories," which has become the general conclusion of the mainstream scientific community.5
Even without accepting the theory of Qi and meridians, science offers several plausible physiological mechanisms to explain the effects of acupuncture. Particularly in relation to pain management, the following mechanisms are being studied 24:
These mechanisms explain why the act of needling can produce physiological effects within the framework of modern neurophysiology, without requiring concepts like Qi or meridians.
However, not all studies negate the specific effects of acupuncture. A study on patients with carpal tunnel syndrome reported that only the real acupuncture group showed a significant improvement in nerve conduction velocity, while the sham acupuncture group showed no change.25 Furthermore, regardless of the theoretical debate, world-renowned medical institutions like Harvard, Mayo Clinic, and Johns Hopkins Hospital have introduced acupuncture for pain management, and top-tier athletes actively use it for conditioning.26 This shows that its utility in the clinical setting is being recognized separately from academic controversies.
Ultimately, the efficacy debate boils down to a clash of 'evidence paradigms.' The RCT of modern medicine is designed to control for all contextual factors to isolate a single variable—the 'active ingredient' of a treatment. In contrast, the TKM treatment model is inherently a holistic and individualized approach where all contextual elements—the diagnostic process, the relationship with the practitioner, the patient's beliefs and expectations—are part of the treatment.4 The 'placebo effect' that RCTs seek to control for may, from a TKM perspective, be a core component of the therapy. Therefore, the fact that RCTs do not clearly demonstrate the superiority of acupuncture may reveal the limitations of the RCT methodology in evaluating complex interventions as much as it reveals the limitations of acupuncture itself.
To understand the scientific basis of the analogy proposed by the user, it is necessary to examine the undiscovered element hypothesis, a field within theoretical chemistry. This provides an important case study of how science deals with unobserved entities.
The currently known periodic table ends with element 118, Oganesson.28 However, theoretical physicists and chemists have long predicted the existence of 'superheavy elements' beyond this limit. The work of Finnish chemist Pekka Pyykkö is a prime example. His model, based on complex Dirac-Fock calculations that account for relativistic effects crucial in superheavy atoms, predicts the chemical properties and electron shell structures of elements up to atomic number 172.6
These predictions are not mere speculation. The Pyykkö model is a mathematically rigorous deduction from the fundamental principles of relativistic quantum mechanics, one of the most successfully verified theories in scientific history.30 Indeed, relativistic effects have been successfully applied to explain existing chemical anomalies, such as why gold is yellow and why mercury is a liquid at room temperature, thereby validating the theory's foundational basis.30
The reason these theoretically predicted superheavy elements have not yet been observed is that they are expected to be extremely unstable with very short half-lives. Synthesizing and detecting them with current technology is extremely difficult, if not impossible.28 Nevertheless, scientists continue to search for an 'island of stability' predicted to exist around element 126 or 164.28 The key point is that these elements, even without direct empirical evidence, are treated as legitimate and valid entities within a firm theoretical framework. Their pursuit is a respected frontier of scientific research.28
This case demonstrates the role of a powerful 'guiding theory' in dealing with the 'unseen.' The search for superheavy elements is not a random endeavor but is guided by a precise mathematical theory (quantum mechanics) that tells scientists what to look for and how. In contrast, the search for Qi and meridians lacks a comparable, universally agreed-upon, predictive formal theory. The theory of TKM is a collection of philosophical principles and empirical correlations inductively generalized from thousands of years of clinical observation.1 This fundamental difference in theoretical origin profoundly affects how these two 'unseen things' are investigated and the types of evidence that can be applied to them.
By systematically comparing the two 'unseen entities'—Qi and meridians, and undiscovered elements—we can gain new insights into the relationship between TKM and science. The purpose of this analogy is not to claim that the two concepts are identical, but to clarify their respective epistemological statuses through their similarities and crucial differences.
Through this analogy, we can re-evaluate the TKM system not as a failed 'pseudoscience,' but as a highly developed 'pre-scientific physiological model.' This model was built on observation, correlation, and functional principles without a material, mechanistic understanding, and it achieved considerable clinical utility. Just as undiscovered elements have meaning within the theoretical framework of quantum mechanics, Qi and meridians have functioned as powerful conceptual tools within the philosophical and clinical framework of Yin-Yang and the Five Elements to explain the complex phenomena of the human body and guide therapeutic interventions.
However, it is crucial to recognize the limitations of this analogy.
The ultimate value of this analogy lies in breaking the deadlock of the dichotomous 'exists/does not exist' debate. By comparing Qi and meridians to another legitimate but unobserved entity within the domain of science, we can adopt a more nuanced and multi-layered perspective. This suggests that the value of the Qi and meridian model may not lie in its literal, physical truth, but in its utility as a conceptual framework for organizing complex clinical information and guiding therapeutic interventions. In other words, we can recognize its value as a successful phenomenological model or a 'useful fiction.'
Table 3: Comparative Analysis of 'Unobserved' Theoretical Constructs
| Attribute | Qi (氣)/Meridian (經絡) System | Predicted Superheavy Elements |
|---|---|---|
| Theoretical Basis | Ancient Philosophy, Clinical Empiricism | Relativistic Quantum Mechanics |
| Nature of Construct | Vitalistic Process, Functional Network | Material Substance, Atomic Structure |
| Predicted Properties | Systemic, Qualitative, Relational | Quantitative, Physical (e.g., mass, half-life) |
| Empirical Status | Indirect Evidence (Clinical Effects), Highly Controversial | Unsynthesized, Unobserved, Theoretical Necessity |
| Method of Inquiry | Clinical Intervention (Acupuncture, etc.), Symptom Tracking | Particle Collision, Spectroscopy |
| Falsifiability | Low (Holistic system with multiple variables) | High (Precise and quantitative predictions) |
The relationship between TKM and science is not static. TKM is constantly evolving by incorporating modern technology, which raises important questions about the future relationship between the two paradigms.
The modern TKM community is actively adopting advanced technology to ensure objectivity and standardization.
'Collaborative practice between Western and Korean medicine,' a unique feature of the Korean healthcare system, demonstrates both the possibilities and difficulties of integrative medicine. Pilot projects have shown positive effects, such as increased patient satisfaction and reduced medical costs for some diseases.40 However, fundamental barriers are also clear. In addition to practical problems like a lack of communication between medical professionals and incompatible Electronic Medical Record (EMR) systems, there is a deep-rooted distrust from the Western medical community, which often regards TKM as unscientific.40 The fact that the vast majority (98.4%) of collaborative referrals are one-way, from TKM to Western medicine, starkly reveals the power imbalance and lack of mutual respect between the two professions.40
The future relationship between TKM and science can be projected into three scenarios:
While true integration remains an ideal, 'coexistence'—gradually expanding the scope of cooperation amidst a tense relationship—appears to be the most realistic future trajectory for now. The final lesson from the analogy of Qi, meridians, and undiscovered elements is that while the quest for the 'unseen' is a driving force that expands the boundaries of knowledge, understanding the nature of the theoretical paradigm that guides that quest is of paramount importance.