Sustainable Medicine for Veterinarians in the New Millennium

Jen-Hsou Lin1, Leang-Shin Wu1, Philip AM Rogers2
1Department of Animal Science, National Taiwan University, Taipei, Taiwan, Republic of China.
2National Beef Research Centre, Teagasc, Grange, Dunsany, Co. Meath, Ireland.

Abstract | Introduction | Sustainable Medicine | Global Challenges | Role of TCM | About TCVM | Science behind TCM (Clinical & Experimental AP | Clinical & experimental HM) | Strategies to merge TCVM & modern Veterinary Medicine (Personal Effort | Societies & Organisations | Co-operation between TCM & TCVM | University Training & Research | Government & Company Support Essential | Love, Respect & Wisdom) | Conclusion | Acknowledgement | Further Reading

ABSTRACT

"Sustainable medicine" (SM) is one that meets not only our needs today but also will meet the needs of succeeding generations. It is a medicine that can be used to maintain good human and animal health and wellbeing into the distant future. Its characteristics are to form a preventive and affordable system from a combination of the best of modern and traditional medicine. It also implies that the main therapeutic materials can be regrown, replaced or replenished after each harvesting with minimal damage to the environment. Though we cannot eliminate all environmental hazards, we must more care of nature and of our environment. Creatures need to live in balance with nature. Appropriate adaptation by and of an effective defence system is the key to health and survival.

In this article, we propose that SM is a new medicine, combining the advantages of modern, and traditional and complementary medical systems to provide better health care service for humans and animals in the 21st century. Firstly we give a brief history of traditional medicine. Then we discuss some clinical and experimental aspects of the combined medicine, and how they could help in many of today's disease problems in humans and animals.

We outline strategies to promote and develop SM and reasons why we should integrate traditional Chinese medicine as an essential part of modern medicine and the role of veterinary science in its development. Lastly we ask research groups, universities, governments, international interests and private companies to support traditional Chinese medicine in every way possible. We hope to achieve a new and sustainable veterinary medicine for the 21st century and that veterinarians of the new age will continue to care for their animal patients in a spirit of love, respect and wisdom.

Key words: acupuncture, alternative, complementary, conventional, environment, herbal, medicine, sustainable, traditional, veterinary.

INTRODUCTION

Like all professions, veterinary medicine is changing rapidly. Several new medicines have been developed for humans and animals during the last decade. Complementary and alternative medicine (CAM) is the best term to describe a new modality that lies outside, or beside, conventional medicine. More recently, the terms, complementary and integrative medicine, have come into use to indicate that they are used with or in addition to conventional therapies. At the end of the 20th century, the American National Institute of Health accepted CAM as a new therapeutic system. As CAM gains acceptance in the field of human medicine, veterinary organisations are beginning to take notice.

In 1996, the American Veterinary Medical Association revised its guideline for CAM in veterinary medicine. These guidelines reflect the current status of the role of these emerging modalities within the parameters of veterinary medicine for use in providing a comprehensive approach to the health care of non-human animals. The category contains acupuncture (AP) and acutherapy, chiropractic, physical therapy, massage therapy, homeopathy, botanical medicine, nutraceutical medicine, and holistic medicine.

A large subset of CAM includes traditional medicine (TM) or natural therapies. They are cultural or ethnic in origin and consist of nutritional, herbal and manual therapies. Our conventional medicine has been called Western medicine (WM). WM uses reductionist philosophy in scientific investigation and in treatment of medical problems. Therefore, WM is also called the scientific medicine or modern medicine. In this text, the authors propose a sustainable medicine (SM) for the next century. We wish to introduce new veterinarians to its philosophy, scientific basis, clinical applications and development.

SUSTAINABLE MEDICINE (SM)

Sustainable development is an idealistic concept that originated from the 1987 report, "Our Common Future", by the United Nation's World Commission on Environmental Development. Sustainability means "meeting the needs of the present without compromising the ability of future generations to meet their own needs". Thus, sustainable development is a process of redirection, reorientation and reallocation. It is a fundamental redesign of economic, technological and sociological processes to address change for a better future of humans. Therefore, SM is one that meets not only our needs today but also will meet the needs of succeeding generations. It is a medicine that can be used to maintain good human and animal health and wellbeing into the distant future. Its characteristics are to form a preventive and affordable system from a combination of the best of modern and traditional medicine. It also implies that the main therapeutic materials can be regrown, replaced or replenished after each harvesting with minimal damage to the environment. Eventually, SM will be an integrative medicine between WM, TM and CAM to provide better care for patients.

We live in nature and depend on nature. If we abuse nature, it will abuse us. Chinese and many other ancient philosophies teach that if we respect nature and care for our environment, prosperity follows and disaster recedes. Public demand is increasing for a more natural system of animal production, care and welfare. Traditional Chinese medicine (TCM) consisted with Chinese herbal medicine, physical medicine (acupuncture, moxibustion, massage etc.) and mental therapy (Qigong, meditation etc.). TCM is one of most natural and sustainable systems of medicine. It has been practised continuously for several millennia in China. The Neijing (Classic of Internal Medicine, 221 BC-220 AD) is the oldest existing medical book in China. It is one of the fundamental texts on TCM, attributed to the legendary Yellow Emperor, Huangdi. It says: "Superior doctors do not treat disease" , i.e. first-class doctors use preventive medicine.

From the viewpoint of the Neijing, SM is ideally a preventive medical system based on effective, safe, readily available, inexpensive and renewable natural products. As few of us are good enough to rely solely on preventive medicine, the need for good clinical medicine will remain. Therefore, we propose that SM is a new medicine, combining the advantages of WM, TCM and CAM medical systems to provide better health care for humans and animals by new doctors and veterinarians in the 21st century.

GLOBAL CHALLENGES

In 20th century, we have developed a vast array of advanced drugs and technologies in WM. In spite of the great cost of WM and western technology, the common diseases remain, or just change their forms from infectious diseases previously to chronic illness now. WM often gives poor results in these disorders, or may be too expensive to use in many parts of the world. Also, WM-induced iatrogenic disease is increasing. In the past 50 years, the incidence of chronic disorders due to stress, dietary imbalances, pollution and many other endogenous and exogenous causes have increased dramatically; psychiatric disorders and suicide are common. Health and contentment depend mainly in being in harmony with our families, our communities, our neighbours and Nature. Today, many people are losing, or ignoring, the vital links with Nature. Today, we must face the consequences of rapid deterioration of our global environment, destruction of the ozone layer, global warming, flooding of coastal communities, climatic change and the spread of mosquito-borne diseases.

Most of these problems are man-made, due mainly to abuse and overuse of the earth's limited resources by science and technology and their discoveries within the 20th century: pollution from domestic, agricultural, industrial and electromagnetic sources and mental and spiritual pollution etc. We all pollute our environment to some extent. We threaten the future survival of our own and other species.

Animals may be poisoned by large doses of antimicrobials, growth-promoters, herbicides, pesticides etc. More often, at lower rates of ingestion, the effects are usually subclinical or difficult to diagnose. Animal fertility and immunity is falling. If residue levels increase in the food chain, these drugs pose a threat to humans who eat contaminated food products. Abuse of fertilisers and agricultural chemicals also threatens animal health; residues enter the human food chain. It is so easy to contaminate our environment! For the sake of our future generations we must consider making major changes in our attitude to WM. This applies to veterinarians as well as medical physicians.

In the next century, our world will be more crowded and interconnected. The world population was about 300 million at the time of Christ, and it took 1800 years for it to reach 1 billion. However, it needed only 12 years for the population to expand from 5 billion to touch 6 billion in 2000. The increasing world population will need more food and resources. A doubling of the population will require a 4-fold increase in agricultural production, a 6-fold increase in energy use and an 8-fold increase in the value of the global economy. In reports of the Food & Agriculture Organisation (1996), over the past 30 years, food production has increased at a rate of circa 1.3% per year whereas human birth rate has increased at 2% per year. Global food supply is falling behind the demand for food. Experts predict that the earth's population will exceed 9 billion people by 2050. We have to ask how many people are enough on this fragile planet. How can we increase food supply for the ever-increasing population when land and water resources are decreasing? How can we ensure environmental sustainability if we produce more food? How can we maintain the quality of human and animal life under such an over-crowded population?

Some people believe that new technologies, such as molecular biology and biotechnology have many solutions to create more productive products to sustain food security, while others see them a tool in the hands of rich corporations with little impact in alleviating worldwide famine and poverty. Today, 1 billion people still suffer from hunger daily and hunger-related deaths exceed 40,000 per day. This silent holocaust is unconscionable. Here, due to complexity and controversy and because we are not expert in this field, we will not discuss in detail whether the genetically modified foods are safe or efficient enough for the ever-increasing population. For many people, the concept of genetically altered, high-tech crop production raised all kinds of questions as regards environmental health, safety and ethics. Actually, no single strategy can overcome all the environmental, technical and economic limitations for feeding such a big population. Even if biotech could raise overall crop productivity by as much as 25%, it is far from being the whole answer. Energy requirement is a good example. Conventional plastics require fossil fuel as a raw material and they are not biodegradable. "Green" (renewable and biodegradable) plastics can be made from sugar from corn and other plants. Biodegradability helps to relieve the problem of disposal of solid-waste, but degradation gives off greenhouse gases, thereby compromising air quality and exaggerating global warming. After all, renewable energy is the essential ingredient to build a sustainable economy but a decreasing demand for energy would be a better choice. To control human populations at a reasonable level and to improve the global environment are good ideas. More practicable ways to solve these global challenges are needed urgently.

The policy of "one child per family" in mainland China during the past 20 years may not be acceptable to all nations but it has effectively limited the population of China to circa 1.3 billion and has improved their living standards significantly. Reduced use of agrichemicals and synthetic drugs for humans and animals is also very important to protect us from environmental hazards. If the best human efforts fail to control the expanding population and environmental hazards, we must all face the realities of hunger, poverty, pollution of all kinds, high levels of competition and stress, increased materialism, high levels of unemployment and the threat of high-tech war.

ROLE OF TRADITIONAL CHINESE MEDICINE (TCM)

Many cultures (Africans, Amerinds, Arabians, Chinese, Egyptians, Europeans, Indians, Japanese, Lapps, Sumerians, Tibetans etc.) evolved their own types of traditional medicine (TM) over centuries. TMs may provide cheap, safe and effective remedies for human and animal patients. Some people argue that TM is not sustainable because it is an important factor leading to extinction of certain plant and animal species. However, the extinction is caused by the greed of people, rather than by TM per se. Stanford University ecologist, Paul Ehrlich, states that the main cause of extinction is not direct human exploitation or malevolence, but the destruction of habitats that results inevitably from the expansion of human populations and human activities. The devastating destruction has taken place in the name of progress during the 20th century. One of major mission for the 21st century is to preserve as much of our natural estate and human heritage as possible. TM is one important part of human heritage. Let us call upon the world's richest nations to provide the money and actions to make that possible. In particular, we call on the richer nations to consider what they can do to prevent or limit the destruction of vast areas of rainforest in South America and Asia. That would not be a charity; it would be a great investment in the future of humans and all life on Earth.

TCM is the oldest, best documented, most complete and integrated system of TM available, though many other TM systems are valuable also. TCM is a Natural Medicine, based on experiences gained over thousands of years and on the idea of Harmony, Balance and Change. Chinese herbal medicine (CHM) and acupuncture (AP) are important parts of TCM. They help the normal adaptive and defensive functions of the body, thus conferring therapeutic and prophylactic effects in many functional and organic diseases. All living creatures need to be in harmony with their environment. They need a balance of hot and cold, work and play, wakefulness and sleep, laughter and tears etc. Change is necessary for life and death. All the methods of TCM (herbs, AP, moxa, massage, exercises etc.) aim to induce Change from the undesired to the desired situation, thereby restoring Balance and Harmony. The effects of TCM are via the natural adaptive responses of the body. Because of its Natural philosophy, its ancient reputation and its excellent clinical success, TCM now has worldwide attention even in wealthy societies such as Japan, the industrialised parts of Southeast Asia, Northern Europe, North America and Oceania.

YI-CHING (The Book of Changes), circa 1000 BC, is a treatise of Chinese philosophy that defines two categories of change: (a) No Change, which means that the principle or activity must be maintained; (b) Change, which means that the principle or activity may be changed or adjusted, depending on the situation. We can simply combine Change and No Change if we want to achieve our goal to a veterinary medicine for the new millennium. TCM is the most obvious partner for WM to help us establish SM for animals.

There are many thousands of experts who could help to teach TCM to others. For those reasons, TCM offers the greatest prospect to integrate traditional and modern systems of medicine. The ideal medicine of the 21st Century would be full integration of TCM and WM. This could simply combine TCM and WM to prevent and treat disease. Of course, a combination between CAM and WM is also very important. To make this become a reality soon, we must begin a gradual change towards holistic, natural medicine (Change) but maintain our duty and role in animal welfare and human benefits (No Change). A symposium on SM for Animals in this Congress investigates the value of this approach.

ABOUT TRADITIONAL CHINESE VETERINARY MEDICINE (TCVM)

As with TCM, TCVM includes CHM and AP. TCVM dates back to the era of the Three Emperors, approximately 10,000 years ago, when Emperor Fusi founded animal husbandry and veterinary medicine in China. According to legend, he taught the Chinese how to domesticate animals and fish and brought civilisation to the primitive society existing in China then. Because of that, Chinese culture venerates Fusi.

Thousands of years before introduction of WM, the Chinese people used their own ways and philosophies to maintain good health and treat disease. They always have relied on animals for food, transport, companionship, military use etc. Doctors and veterinarians must be familiar with both kinds of living creatures. Therefore, many ancient medical books recorded veterinary experience also. The general principles and technique for treating and managing animal diseases are mostly the same as human medicine.

CHM is a phytotherapy, with a strong therapeutic reputation in the East. For millennia, plants, long known to have therapeutic (and poisonous) effects, have been used as medicines. Today, about 75% of the world's population still rely on plants, plant extracts, and other tools of TM to help in basic health needs.

CHM uses a complex combination of medicinal plants and other natural products. These include extracts from living or dead tissue (animal, insect, reptiles, venom, shell, coral etc.) and minerals (mineral salts, certain types of pulverised rocks and soils etc.). CHM uses TCM theory and a TCM diagnosis of the pathological condition of the patient. The Neijing contains the basic theories and clinical applications of HM and AP for humans. It discusses the Theory of Yin/Yang, Five Phases (Elements), Qi (vital energy), AP points, organs, meridians, Blood (Xue), aetiology, diagnostic methods and the differentiation of disease syndromes. Many treatises on HM and AP followed the Neijing.

Acupuncture (AP) literally means needle (acus) puncture but it also includes moxibustion, a type of point cautery. The first written report of veterinary acupuncture (VAP) may be from the West Zhou dynasty (1111 BC-771 BC). It referred to jugular phlebotomy to treat some febrile diseases of horses. During the Qin and Han dynasties (221 BC-220 AD), medical science flourished as communication became more efficient. Sun Yang, a veterinarian in the Qin dynasty published the first book of VAP. Many books on veterinary medicine followed in the next centuries. The most famous was Yuan Heng Liao Ma Ji (A Treatise on Horses, by Yu Ben-Yuan and Yu Ben-Heng in 1608 AD). It describes procedures for use in horses, cattle and camels. From the 19th century up to the beginning of this century, the influx of western ideas demolished much traditional Chinese culture and science. TCM nearly became extinct. In the past 30 years, lack of western medicines has renewed Chinese interest in the techniques of TCM. Development and research into TCM in humans and animals have become popular again throughout China.

SCIENCE BEHIND TCM

Clinical and experimental AP

AP & moxibustion (Chen-chiu (Zhen-jiu) - Needle & Fire) are specialised types of physiotherapy derived from TCM. They stimulate specific points on zones of the body to obtain a therapeutic or analgesic effect. Used properly, AP is a safe technique.

Control of pain, shock, collapse, treatment of alcohol and narcotic addiction and induction of surgical analgesia in humans and animals are the best known uses of AP. Few people know that AP is effective in a much wider variety of human and animal diseases. Some therapeutic effects of AP have been studied experimentally in animals and humans. Experimentally, many factors negate the effects of AP. These include: local anaesthesia of the points, nerve section, nerve block, spinal block, experimental lesions of the midbrain, or use of opiate antagonists or other receptor-activating or blocking-drugs. Other factors enhance AP effects, for example, diphenylalanine (a serotonin precursor), L-tryptophan and domosedan. This suggests AP to be a physical therapy, operating on the defence systems of the body via reflex neural (peripheral, spinal, central, autonomic), neuroendocrine and endocrine pathways.

AP activates the body's defence systems. It influences specific and nonspecific cellular and humoral immunity. It activates cell division, including blood-, reticuloendothelial- and traumatised- cells. It activates leucocytosis, microbicidal activity, antibodies, globulin, complement and interferon. It modulates hypothalamic-pituitary control of the autonomic and neuroendocrine systems, microcirculation, response of smooth and striated muscle and local and general thermoregulation. Applications of AP include inflammation, trauma, tissue healing, burns, ulcers, indolent wounds, ischaemia, necrosis, gangrene, infections, post-infection sequels, fever, auto-immune disease, allergy, anaphylaxis and shock. It treats or prevents side effects of, or sequels to, cerebrovascular disease, coronary heart disease, general anaesthetics, parturition, surgery, cytotoxic chemotherapy and ionizing radiation. It has wide applications in clinical disorders of the respiratory, cardiovascular, digestive, gastrointestinal, urogenital, musculoskeletal and cutaneous systems. AP may inhibit neoplastic cells and can be a useful CAM therapy in Acquired Immunodeficiency Syndrome (AIDS). The effects of AP in stimulating the body's defence systems are involved directly in its therapeutic effects.

AP at GV26 is practical in resuscitation, for example in respiratory and cardiac arrest under general anaesthesia. AP is used widely in cervical and thoracolumbar disc disease (spinal pain and/or paralysis) in dogs. Many affected animals that had failed to respond to WM recovered after AP treatment. AP was successful in treating a lion with idiopathic paralysis. The AP effect involves the autonomic and peripheral nervous system, improved local circulation and muscle function. AP is commonly used to treat reproductive disorders (including anoestrus and cystic ovaries), dystocia and prolapsed uterus in sows, cows, bitches and mares. A needle implanted at Pi-Kao (between the nostrils) ended broodiness in domestic hens. The effect occurred in 2 1.8 days, compared with 14 9.2 days in controls and 14 9.8 days in hens treated with clomiphen citrate (a hormone treatment).

AP stimulation of certain points historically associated with reproduction altered blood levels of LH, FSH, oestradiol and progesterone. Activation of the central control system, mediated by the hypothalamus and pituitary, may explain these phenomena. The short-term effect of Electro-AP (EA) at Baihui and Weiken in sows lowered plasma LH levels in 1-2 hours. Endorphins depress LH, whereas naloxone can induce an LH surge. Endorphins may mediate the EA effect. In the long-term, EA increased the frequency and amount of the pulsatile release of LH and increased plasma progesterone levels 4-6 hours after stimulation, especially on the next day.

Recently, we evaluated the pituitary responsiveness of gilts treated with EA in response to gonadotrophin-releasing hormone (GnRH) injection. EA treatment at reproductive-related AP points had diverse effects on pituitary function in response to GnRH stimulation: pituitary responsiveness decreased (reducing LH release) in the hours post-EA but the pituitary became more sensitive after some days and then triggered a new situation for trophic hormone stimulation. The action of EA on the brain and pituitary gland is complex and needs more research.

In the 1970's, western research confirmed the analgesic effect of AP. Since then, the study and application of AP methods have increased rapidly throughout the world. VAP is rapidly becoming accepted worldwide in veterinary science. International journals report clinical and basic VAP research more frequently today.

Clinical and experimental HM

CHM and Kampo medicine (KM, a Japanese style of CHM) always use formulations (multiple ingredients) rather than a single herb. A formulation usually has 4-10 herbs with a complex guideline of treatment theory that is mainly to maintain harmony of body functions and to expel pathogens. Many ingredients are to enhance the effects of, or to act as antidotes to unwanted effects of, other ingredients. The formulations come in many forms: shredded and dried (like tea for home-decoction), ready-to-use decoctions, pills, powders, pastes, ointments, balms and injections.

Documentation of TCM is >3000 years old. Thus, there are extensive data and cumulative experience on the use of CHM. For example, the treatise Shang Han Lun by Chang Chung-Ching (142-220 AD) recorded the use of Koken-Huanglien-Huangchin-Tang (KHHT) that has pueraria (Koken), coptis (Huanglien), scute (Huangchin) and liquorice in a 6:3:3:2 ratio. KHHT is a common formula for dysentery and gastroenteritis in children. It also controls symptoms of 'flu, fever, erysipelas, measles, some eye disorders, headache, toothache. Experimentally, gentamycin and KHHT were highly (and equally) effective (88 and 85% respectively) in treating piglet scour. In that trial 52% of controls were dry by 4 days. However, this does not mean that KHHT works like antibiotics. The mechanism of KHHT is a holistic treatment. It enhances the body defence system, improves gastrointestinal function and anti-microbial action, etc.

In this symposium, Dr. K. Kaphle from Nepal presents Indian data on HM for veterinary use. He shows that, as compared with WM alone, the combination of WM and Indian HM helped to prevent brooding stress and decreased mortality in hens. The same results were obtained in bovine mastitis. Those are good examples of SM for preventing and treating animal diseases.

Clarification of the active principle(s) and/or mode(s) of action of HM may lead to better understanding of the mode of action at molecular levels. It also may help us to evaluate therapeutic efficacy, to maintain herbal quality and to the develop novel drugs. This may provide remedies for disease incurable by modern chemotherapeutics. Herbs have active low (alkaloids, terpenoids, saponins, flavonoids) and high (protein, tannin, polysaccharide) molecular weight substances with wide-ranging effects: insect repellents, immunomodulators, and agents with hypoglycaemic, sedative, anti-cancer, anti-inflammatory, anti-viral, anti-bacterial, anti-protozoal, anti-oxidant and anti-liver disease activity.

HM is the main branch of TM that can make a similar, if not greater, contribution to international veterinary practice as AP has done already. This will occur only if we make a great research effort to verify the efficacy and safety of HM. Recently, increasing numbers of western veterinarians have become interested in the use of HM. The problem with this new interest is that many veterinarians are beginning to use these techniques without adequate training, or by trial and error, rather than strict scientific investigation.

STRATEGIES TO MERGE TCVM AND MODERN VETERINARY MEDICINE

Western veterinary medicine and TCVM derive from different backgrounds: the former is objective and scientific, while the later is subjective and empirical. Each system has its own advantages and disadvantages. If we can combine the advantages of both systems and avoid the disadvantages, it may be possible to create a synergistic system of medicine for animals. The use of medicinal herbs in China spans thousands of years and the documentation is extensive. HM may provide new methods to treat animal and human disease if modern veterinary science evaluates its historical therapeutic claims.

Recent development in biotechnology has shown that the main factors needed to develop any science are personal effort, group effort, the activities of interested organisations, teaching and training at university level and financial support from governments. Although modern veterinary medicine in China is underdeveloped, all these factors are present. However, most other countries lack these factors. Fortunately, the developed countries may use their modern facilities in veterinary science and their educational systems to study and develop TCVM, including CHM. Some suggestions to help such developments are presented below.

Personal effort

Although personal effort might seem the least powerful force in the development of CHM in veterinary science, nothing worthwhile can occur without such effort. Therefore, it is essential to encourage veterinarians and students to become involved. Interested societies may play a role in recruitment and by providing basic information and group discussion. Some VAP societies are beginning to study CHM as part of their activities.

Societies and organisations

In 1974, the late H. Grady Young and his colleagues founded IVAS - the International Veterinary Acupuncture Society. Through the efforts of IVAS, and of other Societies, many countries have accepted AP as a valid therapeutic modality. Today, VAP is available in more than 40 countries.

Interested societies may promote TCM by offering courses, publishing journals and organising symposia. Individual veterinarians may contact IVAS at POB 1478, Longmont, CO., 80502, USA [Web Page http://www.ivas.org (E-mail: ivasoffice@aol.com) or their national veterinary acupuncture society [http://www.komvet.at/ivadkom/vapsocs.htm].

International organisations and congresses also promote TM activities. The 1995 World Veterinary Congress XXV (Yokohama, Japan) provided several sections for veterinary Oriental medicine including HM and AP, and the 1999 Congress XXVI (Lyon, France) also opened some Veterinary AP symposia for the participants. This FAVA Congress encourages integration of TCVM into all phases of veterinary practice and hosts sessions on SM for animals for the veterinary profession of the new millennium. Hopefully, this trend will continue, especially in the FAVA region.

Co-operation between TCM and TCVM

TCM is much more advanced than TCVM. Veterinarians should be encouraged to seek frequent contact with human medical doctors. Mutual exchange of information between the two fields improves clinical results and both sides benefit from the shared experience. Some national VAP societies have excellent contact with medical AP experts.

University training and research

Universities are centres of education and science. Advancement of TCM and, especially research in TCM, needs their wholehearted involvement. Unfortunately, courses in TCM at undergraduate or postgraduate level are rare at western universities. Part of the reason is that they have no member(s) of staff qualified to teach the system. Only a few veterinary schools in Europe, America and Australia offer basic AP classes. Guest lecturers from IVAS, or from the national or nearby groups, give most of the classes. Western veterinary schools should send faculty members to study AP in China, or invite experts in TCM to come to teach. Also, relevant research must be supported financially.

Government and company support essential

Investment by governments is essential for development of modernised TCM. We should also seek support from farsighted pharmaceutical companies. Adequate financial support for research and training will speed up the achievement of results. Unfortunately, present levels of support for research on TM is very small.

Love, respect and wisdom

Love, respect and wisdom are three spiritual forces essential to foster SM and create a beautiful world that maintains balance between change and no change. Love changes all and produces beauty. Respect brings understanding and creates kindness. Wisdom makes sense and perception of truth. Ultimately, our best hope may be that even where governments lag, veterinarians in the Asia-Pacific region in the new millennium understand the urgent need for SM in the 21st century. If we want to exploit this understanding we must start to act on a large scale now. In doing so, we will continue to bring the best of TMs to more and more people and create a more peaceful life for the future.

CONCLUSION

If we can stimulate widespread research, development and usage of TCM and CAM, the savings on the international cost of conventional drugs could be billions of dollars annually. This would force a major change in the western pharmaceutical industry and would, initially at least, have serious effects on investment and jobs. We must expect that vested interests in conventional industries will resist fiercely any major change to TCM/CAM. However, we may be able to tempt the major pharmaceutical industries to diversify slowly into this movement. In this way, they could save many old jobs and create new jobs. New areas would include biological research, breeding, refining, tending, processing and replenishing the herbs, researching the active principles, upgrading quality control, refining the combinations of medicines to eliminate any risk of toxicity or adverse side-effects, etc.

Veterinary medicine is developing and expanding. The integration of TCVM and CAVM with conventional medicine is inevitable. The only questions that remain are when and how. The future requires us to take the most efforts to achieve the SM. The motto of IVAS just reflects the altitude of veterinarians in the new millennium:

"It matters not whether medicine is old or new, so long as it brings about a cure.
It matters not whether theories are eastern or western, so long as they prove to be true."

We have the opportunity to make great changes to benefit human-, animal- and plant- health and wellbeing for the next millennium. Ultimately, love, respect and wisdom are three crucial factors to drive our transition to a sustainable medicine. The future of SM is now.

ACKNOWLEDGEMENT

We thank the Organising Committee of the 11th Federation of Asian Veterinary Association and the Chinese Society of Veterinary Science for the invitation to present and publish this article.

FURTHER READING