《洛杉磯時報》在2007年1月8日頭版頭條刊登記者M(jìn)ark
Magnierd的報道《中國發(fā)生的解剖刀對草藥之戰(zhàn)》（Scalpel vs. herb in China，網(wǎng)絡(luò)版的標(biāo)題為China's
medicine
wars），報道新近發(fā)生在中國的中醫(yī)之爭，文中大量報道支持中醫(yī)一方的辯護(hù)，但對反對中醫(yī)一方的觀點(diǎn)主要只引用了我的一句話：“許多被認(rèn)為無毒的草藥實(shí)
際上毒性很大，”生化學(xué)者、專欄作家和一個揭露學(xué)術(shù)造假網(wǎng)站的創(chuàng)始人方舟子說。“但是從業(yè)者和支持者用各種借口加以掩蓋。”（"Many herbal
medicines considered innocuous are actually very toxic," said Fang
Zhouzi, a biochemist, columnist and founder of a website that targets
academic fraud. "But practitioners and proponents cover this up using
various excuses."）
我當(dāng)初接受該記者的電子郵件采訪時，回答了14個問題，現(xiàn)把問答翻譯成中文如下。英文原文附后。
1. 你認(rèn)為中醫(yī)現(xiàn)在的問題是什么？
答：最大的問題是安全性問題。生物醫(yī)學(xué)研究已表明許多種被中醫(yī)認(rèn)為無毒的草藥實(shí)際上有很強(qiáng)的毒性，能夠?qū)е聡?yán)重疾病，例如腎病、癌癥、肝炎等等。但是
公眾還未充分注意到這個問題，而中醫(yī)從業(yè)者和支持者正用種種借口加以掩蓋。中藥至今還普遍被吹噓為“沒有任何毒性和副作用的天然藥物”，而且通常不列出其
可能的副作用。
另一個問題是中醫(yī)從業(yè)者慣于夸大、捏造其有效性并愚弄了太多的人。雖然幾乎沒有一種中醫(yī)療法通過了雙盲、隨機(jī)分組、有安慰劑對照的臨床試驗(yàn)，但是許多
中國人仍然相信中醫(yī)是一直就是最好的醫(yī)學(xué)、能夠治療幾乎任何疾病。民族自豪感使這個問題變得復(fù)雜，對許多中國人來說批評中醫(yī)是不可想像的，幾乎就像是在叛
國。
因?yàn)橹嗅t(yī)藥并非真正有效，所以有一個很普遍的現(xiàn)象是，把化學(xué)藥物添加到中藥中然后做為純中藥銷售。這種欺詐行為對病人來說也是非常危險的。
2. 有很多假醫(yī)生和濫用嗎？
答：是的。
3. 是否有許多沒有受過訓(xùn)練的人試圖騙人并獲益？
答：是的。
4. 你認(rèn)為中醫(yī)是不科學(xué)的嗎？請解釋。
答：中醫(yī)不是建立在科學(xué)基礎(chǔ)上的，而是建立在玄學(xué)、巫術(shù)和傳聞基礎(chǔ)上的，加上一些民間醫(yī)術(shù)。它的理論體系基本上不具有可檢驗(yàn)性和測量性，而且完全與現(xiàn)
代科學(xué)不兼容。它更像是一種宗教，仍然在崇拜數(shù)百年前寫的古代醫(yī)學(xué)著作。中醫(yī)從業(yè)者通常引用古代醫(yī)學(xué)著作做為他們進(jìn)行診斷和治療的依據(jù)。有沒有一門科學(xué)只
在一個國家獲得承認(rèn)和實(shí)踐，完全與其他科學(xué)不相干，并且崇拜古代著作？那將會是一門非常特殊的科學(xué)。
5. 你認(rèn)為中國依賴中醫(yī)還有哪些問題？
答：即使在經(jīng)過恰當(dāng)?shù)尼t(yī)學(xué)治療之后，中國的病人通常還被要求花費(fèi)額外的錢去購買不必要的、昂貴的中藥，這是一種浪費(fèi)。
而且，已經(jīng)浪費(fèi)了大量的公共資金試圖用“科學(xué)”證明中醫(yī)理論，例如試圖證明經(jīng)絡(luò)的存在。
6. 西醫(yī)中有哪些是中醫(yī)不能提供的？
答：雖然現(xiàn)代醫(yī)學(xué)起源于西方，但是它不屬于西方，因此我更喜歡用“現(xiàn)代醫(yī)學(xué)”、“醫(yī)學(xué)科學(xué)”的說法，而把“西醫(yī)”一詞留給傳統(tǒng)的西方醫(yī)術(shù)，例如順勢療
法。現(xiàn)代醫(yī)學(xué)能夠做手術(shù)，防治多種疾病（特別是傳染病），這些是中醫(yī)做不到的。甚至就慢性病而言，也沒有科學(xué)證據(jù)證明中醫(yī)比現(xiàn)代醫(yī)學(xué)更安全可靠。現(xiàn)代醫(yī)學(xué)
之所以更安全可靠，是因?yàn)樗墙⒃趤碜詫?shí)驗(yàn)和隨機(jī)臨床試驗(yàn)的科學(xué)證據(jù)基礎(chǔ)上的。
7. 某些成分是否有什么問題？它們是否有時候是不安全的？
答：許多中藥含有有毒成分。例如，20多種中草藥含有馬兜鈴酸，這是已知的一種腎毒性毒素和可能的致癌物。有許多醫(yī)學(xué)報道表明病人由于使用了含馬兜鈴酸的草藥而導(dǎo)致腎衰竭。許多中藥含有高含量的朱砂和雄黃，能夠?qū)е鹿蜕橹卸尽?br>
8. 你是否有案例表明人們因?yàn)槭褂弥兴幎劳龌蚴共∏榧又兀?br>
答：自1993年以來，西方研究人員已發(fā)現(xiàn)含有馬兜鈴酸的草藥是強(qiáng)烈的腎毒素，但是中國政府和中醫(yī)從業(yè)者拒絕這一發(fā)現(xiàn)，直到2003年才承認(rèn)這個問
題。因?yàn)橛羞@10年的耽誤，估計(jì)有十幾萬中國患者因?yàn)榉昧擞芍闹兴帍S家北京同仁堂生產(chǎn)的含馬兜鈴酸的非處方著名藥物龍膽瀉肝丸而得了腎衰竭，需要做
腎移植或做血液透析。一些受害者已起訴北京同仁堂。
兩年前，我的一位近親因胃癌病故。多年來他為了治胃疼和消化不良，只看中醫(yī)、吃中藥。等到他最終被送往醫(yī)院時，已是胃癌晚期，已無法進(jìn)行恰當(dāng)?shù)闹委煛?br>
9. 是否有些成分對全球環(huán)境有害，例如使用瀕危動物成分？
答：是，中醫(yī)根據(jù)取象比類的巫術(shù)原則，至今還把犀角、虎骨、虎鞭、熊膽和其他瀕危動物的器官當(dāng)成寶貝。
10. 對改革中醫(yī)你有什么建議？
答：中國可能是世界主要國家中唯一一個有兩套獨(dú)立的醫(yī)學(xué)“科學(xué)”，并對中醫(yī)采用一套非常不同的、非常低的標(biāo)準(zhǔn)。我們不應(yīng)該把中醫(yī)當(dāng)成另一種合理的“醫(yī)
學(xué)科學(xué)”，而是應(yīng)該當(dāng)成另類醫(yī)術(shù)。它的理論體系應(yīng)該被完全拋棄，而它的有效性和安全性應(yīng)該用科學(xué)方法進(jìn)行充分的檢驗(yàn)。我們對中醫(yī)和現(xiàn)代醫(yī)學(xué)都應(yīng)該采用相同
的嚴(yán)格標(biāo)準(zhǔn)。
11. 你是否認(rèn)為中國醫(yī)療保險系統(tǒng)應(yīng)該包括中醫(yī)藥？
答：既然大多數(shù)中國人相信并使用中醫(yī)藥，滿足他們的要求我想是合理的。
12. 毛澤東說過需要中西醫(yī)相結(jié)合。對這個觀念你怎么認(rèn)為？
答：你能夠把占星術(shù)和天文學(xué)、煉金術(shù)和化學(xué)相結(jié)合嗎？把兩個不兼容的系統(tǒng)相結(jié)合是不可能的。它從未有效。它只是給醫(yī)生們一個借口，開不必要的中藥去賺病人更多的錢。但是當(dāng)然了，在經(jīng)過充分的科學(xué)研究之后，某些有價值的草藥和民間醫(yī)術(shù)可以被現(xiàn)代醫(yī)學(xué)所吸收。
13. 中國政府正在尋求為中醫(yī)申請世界遺產(chǎn)，并似乎把它做為中國文化輸出和海外形象的一部分。對這種觀點(diǎn)你有什么看法？
答：我支持讓中醫(yī)成為文化遺產(chǎn)，并把它放進(jìn)博物館。中醫(yī)是一種文化遺產(chǎn)，雖然不是科學(xué)。
14. 在中國有越來越多的人懷疑中醫(yī)的價值的同時，西方國家中似乎有越來越多的富人在擁抱中醫(yī)。對此你有什么看法？
答：我把這當(dāng)成西方國家中反科學(xué)、反文化運(yùn)動的一部分。既然現(xiàn)代醫(yī)學(xué)不能治愈所有的疾病，那么另類醫(yī)術(shù)和任何偽科學(xué)和迷信一樣，總是能夠利用人們的無知和弱點(diǎn)，將會有生存和生長的土壤。
RE: interview request from L.A.Times
1. What problems do you see with TCM these days?
The biggest problem is the safety. Biomedical research has shown that
many herbal medicines considered as innocuous by TCM are actually very
toxic and can cause serious diseases, such as renal disease, cancers,
hepatitis, etc. But the public haven't been fully aware of this
problem, and TCM practitioners and proponents are covering it up using
various excuses. TCM is still generally advertised as a "natural
medicine without any toxic and side effects", and usually doesn't list
its possible side effects. Another problem is that TCM practitioners
are used to make exaggerative and dubious claims about its efficacy and
fool too many people. Although almost none of TCM treatments has passed
double-blind, random-assignment, placebo-controlled test, most Chinese
believe that TCM has always been the best medicine and can cure almost
any diseases. The national pride complicates the issue, and criticizing
TCM is unthinkable to many Chinese people and almost like committing a
traitorous act. Because TCM is not really effective, it's very common
that chemical medicine is added into TCM medicine and sold as pure TCM
medicine. This cheating practice is also very dangerous to patients.
2. Are there a lot of fake doctors and abuses?
Yes.
3. Do some people try and get rich or take advantage of people without having the training?
Yes.
4. Do you think it is not scientific? Please explain.
TCM is not based on science, but based on mysticism, magic and
anecdote, plus some folk remedies. Its theoretical system is generally
untestable and unmeasurable, and is totally incompatible with modern
science. It's more like a religion, which still worships ancient
medical works written hundreds of years ago. TCM practitioners often
cite ancient medical works as their basis to make diagnosis and
treatment. Is there any science that is recognized and practiced in
only one nation, completely independent from other sciences, and
worships ancient works? That will be a very special science.
5. What other problems do you see with China's reliance on TCM?
Even after proper medical treatments, Chinese patients are usually
asked to spend extra money to buy unnecessary expensive TCM medicines,
which it's a waste.It has also wasted a lot of public funds to
"scientifically" prove the theory of TCM, e.g., try to demonstrate the
existence of meridians.
6. What does Western medicine offer that TCM does not?
Although modern medicine first appeared in the West, it does not
belong to the West anymore. Therefore I prefer the term of "modern
medicine" or "medical science" to "Western medicine", and reserve the
term "Western medicine" for traditional Western medicine, such as
homeotherapy. Modern medicine can perform surgical operations, prevent
and cure a lot of disease (particularly infectious disease), which TCM
can't. Even to those chronic diseases, there is not scientific evidence
that TCM is more reliable and safer than modern medicine. Modern
medicine is more reliable and safer because it's based on scientific
evidence from experiments and randomized clinical trials.
7. What is the problem with some of the ingredients? Are they sometimes unsafe?
Many TCMs contain toxic ingredients. For instance, more than 20
herbal medicines contain aristolochic acid, a well-known nephrotoxin
and potential carcinogen. There are a lot of reports that patients
developed end-stage renal disease in association with the use of herbal
medicines containing aristolochic acid. Many TCMs contain high amounts
of vermilion and realgar, and can cause mercury and arsenic poisoning.
8. Do you have examples of cases where people have died or become worse
from using TCM?
Since 1993, Western researchers have shown that herbal medicines
containing aristolochic acid are potent nephrotoxin, but Chinese
government and TCM practitioners refused this finding until 2003.
Because this 10-year delay, it is estimated that more than 100
thousands of Chinese patients developed end-stage renal disease and
required renal transplant or dialysis because they took Long Dan Xie
Gan Wan, a popular OTC herbal medicine containing aristolochic acid and
produced by the famous TCM manufacturer Beijing Tongrentang. Some
victims have sued Beijing Tongrentang.Two years ago, one of my close
relatives died from stomach cancer. For many years he only saw TCM
practitioners and took TCM to treat stomach pain and dyspepsia. When he
was finally sent to the hospital, he had developed terminal stomach
cancer and was too late to have proper treatments.
9. Are some of the ingredients bad for the global environment, i.e. using endangered animal parts?
Yes, based on principles of sympathetic magic, TCM still treasures
rhinoceros horns, tiger bones and penises, bear gall bladders and other
endangered animal parts.
10. What would you propose to reform TCM?
China is probably the only major country in the world that has two
independent medical "sciences", and applies a very different, very low
standard to TCM. We shouldn't consider TCM as another legitimate
"medical science", but an alternative medicine. Its theoretical system
should be completely abandoned, and the efficacy and safety of TCM
should be fully tested using scientific methods. We should apply the
same rigorous standard to both TCMs and modern medicine. 11. Do you
think the Chinese medical insurance system should cover TCM?
Since the majority of Chinese people believe and use TCM, I think it's reasonable to fulfill their requirement.
12. Mao spoke of the need to marry Eastern and Western medicine. What do you think of this idea?
Can you marry astrology and astronomy, alchemy and chemistry? It's
impossible to combine two incompatible systems. It never works. It only
gives doctors an excuse to charge patients more by prescribing
unnecessary TCM. But of course, some valuable herbal medicines and folk
remedies can be absorbed into modern medicine after sufficient
scientific investigation.
13. The government is seeking heritage status for TCM and seems to
view it as a part of China's cultural export and image overseas. What
do you think of that idea?
I support to seek cultural heritage status for TCM and put it into museum. TCM is a cultural, although unscientific, heritage.
14. It seems like more rich people in Western countries are embracing
TCM while more people in China question its value. Why do you think
that is?
I consider it as part of anti-science and anti-culture movement in
Western countries. Since modern medicine can't cure every disease, the
alternative medicines, like any pseudo-sciences and superstitions, can
always exploit people's ignorance and weakness, and will have soils to
survive and grow.