《洛杉磯時報》在2007年1月8日頭版頭條刊登記者Mark Magnierd的報道《中國發生的解剖刀對草藥之戰》（Scalpel vs. herb in China，網絡版的標題為China's medicine wars），報道新近發生在中國的中醫之爭，文中大量報道支持中醫一方的辯護，但對反對中醫一方的觀點主要只引用了我的一句話：“許多被認為無毒的草藥實 際上毒性很大，”生化學者、專欄作家和一個揭露學術造假網站的創始人方舟子說。“但是從業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."）

我當初接受該記者的電子郵件采訪時，回答了14個問題，現把問答翻譯成中文如下。英文原文附后。

1. 你認為中醫現在的問題是什么？

答：最大的問題是安全性問題。生物醫學研究已表明許多種被中醫認為無毒的草藥實際上有很強的毒性，能夠導致嚴重疾病，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，而中醫從業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。

另一個問題是中醫從業者慣于夸大、捏造其有效性并愚弄了太多的人。雖然幾乎沒有一種中醫療法通過了雙盲、隨機分組、有安慰劑對照的臨床試驗，但是許多 中國人仍然相信中醫是一直就是最好的醫學、能夠治療幾乎任何疾病。民族自豪感使這個問題變得復雜，對許多中國人來說批評中醫是不可想像的，幾乎就像是在叛 國。

因為中醫藥并非真正有效，所以有一個很普遍的現象是，把化學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. 有很多假醫生和濫用嗎？

答：是的。

3. 是否有許多沒有受過訓練的人試圖騙人并獲益？

答：是的。

4. 你認為中醫是不科學的嗎？請解釋。

答：中醫不是建立在科學基礎上的，而是建立在玄學、巫術和傳聞基礎上的，加上一些民間醫術。它的理論體系基本上不具有可檢驗性和測量性，而且完全與現 代科學不兼容。它更像是一種宗教，仍然在崇拜數百年前寫的古代醫學著作。中醫從業者通常引用古代醫學著作做為他們進行診斷和治療的依據。有沒有一門科學只 在一個國家獲得承認和實踐，完全與其他科學不相干，并且崇拜古代著作？那將會是一門非常特殊的科學。

5. 你認為中國依賴中醫還有哪些問題？

答：即使在經過恰當的醫學治療之后，中國的病人通常還被要求花費額外的錢去購買不必要的、昂貴的中藥，這是一種浪費。

而且，已經浪費了大量的公共資金試圖用“科學”證明中醫理論，例如試圖證明經絡的存在。

6. 西醫中有哪些是中醫不能提供的？

答：雖然現代醫學起源于西方，但是它不屬于西方，因此我更喜歡用“現代醫學”、“醫學科學”的說法，而把“西醫”一詞留給傳統的西方醫術，例如順勢療 法。現代醫學能夠做手術，防治多種疾?。ㄌ貏e是傳染?。@些是中醫做不到的。甚至就慢性病而言，也沒有科學證據證明中醫比現代醫學更安全可靠?，F代醫學 之所以更安全可靠，是因為它是建立在來自實驗和隨機臨床試驗的科學證據基礎上的。

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。有許多醫學報道表明病人由于使用了含馬兜鈴酸的草藥而導致腎衰竭。許多中藥含有高含量的朱砂和雄黃，能夠導致汞和砷中毒。

8. 你是否有案例表明人們因為使用中藥而死亡或使病情加重？

答：自1993年以來，西方研究人員已發現含有馬兜鈴酸的草藥是強烈的腎毒素，但是中國政府和中醫從業者拒絕這一發現，直到2003年才承認這個問 題。因為有這10年的耽誤，估計有十幾萬中國患者因為服用了由著名的中藥廠家北京同仁堂生產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、吃中藥。等到他最終被送往醫院時，已是胃癌晚期，已無法進行恰當的治療。

9. 是否有些成分對全球環境有害，例如使用瀕危動物成分？

答：是，中醫根據取象比類的巫術原則，至今還把犀角、虎骨、虎鞭、熊膽和其他瀕危動物的器官當成寶貝。

10. 對改革中醫你有什么建議？

答：中國可能是世界主要國家中唯一一個有兩套獨立的醫學“科學”，并對中醫采用一套非常不同的、非常低的標準。我們不應該把中醫當成另一種合理的“醫 學科學”，而是應該當成另類醫術。它的理論體系應該被完全拋棄，而它的有效性和安全性應該用科學方法進行充分的檢驗。我們對中醫和現代醫學都應該采用相同 的嚴格標準。

11. 你是否認為中國醫療保險系統應該包括中醫藥？

答：既然大多數中國人相信并使用中醫藥，滿足他們的要求我想是合理的。

12. 毛澤東說過需要中西醫相結合。對這個觀念你怎么認為？

答：你能夠把占星術和天文學、煉金術和化學相結合嗎？把兩個不兼容的系統相結合是不可能的。它從未有效。它只是給醫生們一個借口，開不必要的中藥去賺病人更多的錢。但是當然了，在經過充分的科學研究之后，某些有價值的草藥和民間醫術可以被現代醫學所吸收。

13. 中國政府正在尋求為中醫申請世界遺產，并似乎把它做為中國文化輸出和海外形象的一部分。對這種觀點你有什么看法？

答：我支持讓中醫成為文化遺產，并把它放進博物館。中醫是一種文化遺產，雖然不是科學。

14. 在中國有越來越多的人懷疑中醫的價值的同時，西方國家中似乎有越來越多的富人在擁抱中醫。對此你有什么看法？

答：我把這當成西方國家中反科學、反文化運動的一部分。既然現代醫學不能治愈所有的疾病，那么另類醫術和任何偽科學和迷信一樣，總是能夠利用人們的無知和弱點，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.