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Table of Contents
REVIEW ARTICLE
Year : 2020  |  Volume : 3  |  Issue : 1  |  Page : 15-21

Tacit knowledge mining: The key traditional chinese medical inheritance


1 Department of Geriatrics Division II, Xiyuan Hospital, China Academy of Chinese Medical Sciences; Institute of Geriatric Medicine, China Academy of Chinese Medical Sciences, Beijing, China
2 Department of Geriatrics Division II, Xiyuan Hospital; Institute of Geriatric Medicine, China Academy of Chinese Medical Sciences; Peking University Health Science Center, Beijing, China
3 Cardiovascular Diseases Centre, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China

Date of Submission03-Dec-2019
Date of Acceptance21-Jan-2020
Date of Web Publication27-Mar-2020

Correspondence Address:
Dr. Fengqin Xu
Xiyuan Hospital, China Academy of Chinese Medical Sciences, No. 1 Xiyuan Playground, Haidian District, Beijing 100091
China
Yue Liu
Xiyuan Hospital, China Academy of Chinese Medical Sciences, No. 1 Xiyuan Playground, Haidian District, Beijing 100091
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/CMAC.CMAC_2_20

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  Abstract 


Traditional Chinese medicine (TCM) is a treasure of traditional Chinese culture and a gift to the world. TCM tacit knowledge refers to the knowledge and experiences formed in the process of learning and practice of TCM. The objective of this study is to discuss the importance of TCM tacit knowledge in the inheritance and education of TCM. As the essence of the TCM, TCM tacit knowledge has the characteristics of massive, complicated, relativistic, highly individualized, constantly innovative, the dependence of cultural background and the regional environment, as well as difficult to explicate. It exists in every aspect of the TCM theory and the process of dialectical treatment. Besides the traditional master-apprentice, family-based, school-based, and inheritance and education methods, together with the inheritance based on the books, images, and network platforms, in the process of TCM modernization, a variety of modern theoretical models and computing techniques have also been used in the mining of the TCM tacit knowledge. In this study, we introduced the usage of SECI model, complexity adaptive system, latent variable model, and some of the data mining technologies in the TCM tacit knowledge mining. An accurate and efficient inheritance of TCM tacit knowledge is the key to maintain the vitality and innovative development of TCM. Under the reasonable application and combination of the traditional education methods, modern mining methods, and further the artificial intelligence, the explicit and inheritance of TCM tacit knowledge will get tremendous development, and it could extremely improve the efficiency and accuracy of the TCM inheritance and the TCM modernization.

Keywords: Inheritance, mining method, tacit knowledge, traditional Chinese medicine modernization, traditional Chinese medicine


How to cite this article:
Lan X, Zhao J, Zhang Y, Chen Y, Yan Y, Liu Y, Xu F. Tacit knowledge mining: The key traditional chinese medical inheritance. Chin Med Cult 2020;3:15-21

How to cite this URL:
Lan X, Zhao J, Zhang Y, Chen Y, Yan Y, Liu Y, Xu F. Tacit knowledge mining: The key traditional chinese medical inheritance. Chin Med Cult [serial online] 2020 [cited 2020 Sep 22];3:15-21. Available from: http://www.cmaconweb.org/text.asp?2020/3/1/15/281476




  Introduction Top


Knowledge, which includes the descriptions of facts and information, as well as the skills acquired in education and practice, is the outcome of human being's understanding of the external world through practice. The ancient Greek philosopher Plato (427–347 BC) believes that knowledge should be clear and can be expressed in words.[1] However, the Hungarian-British physical chemist and philosopher Michael Polanyi (1891 – 1976) thinks that “we know more than we can tell.” In addition to Plato's explicit knowledge, there is tacit knowledge that can only be sensed but hard to be expressed. Traditional Chinese medicine (TCM) is a medical system formed and inherited by the Chinese nation through the exploration, accumulation, and practice of the relationship between natural world and human bodies for 1000 of years. Based on abundant basic theories and clinical practices of TCM, the therapeutic methods of the TCM doctors are much more individual and flexible. In this view, TCM doctors accumulate plenty of individualized experiences with the characteristics of tacit knowledge. Thus, TCM tacit knowledge refers to the knowledge and experiences formed in the process of learning and practice of TCM; it is highly individualized, unspeakable, and difficult to be explicated. For the TCM, tacit knowledge is the foundation of explicit knowledge and the key to the clinical therapeutic effect of TCM. It also implies greater excavating and creating value in the inheritance of TCM.


  Characteristics Of Traditional Chinese Medicine Tacit Knowledge Top


TCM tacit knowledge has some characteristics. First, massive, complicated, and relativistic. As the basis of TCM, tacit knowledge, which has a massive number, diversified forms, widespread ranges, and complex contents, exists in every aspect of the TCM theory and the dialectical treatment of each TCM doctor. Second, the dependence of cultural background and the regional environment. TCM was bred from traditional Chinese culture. The formation and development of TCM also are the miniatures and symbols of the evolution of traditional Chinese culture.[2] The abundant and varied traditional Chinese culture plays an invisible and irreplaceable role in the formation and innovation of TCM doctors' outlook on life and value, thought patterns, and knowledge theories.[3] Similarly, China is vast in territory from ancient times to the present. The climatic, natural, and humanistic environments of different regions vary greatly, which could come into different effects on the physical, physiological, and psychological status of the inhabitants.[3],[4] Thus, although with the same TCM syndrome, the treatment therapy and prescriptions used in different regions with distinctive geographical environments can be quite different. Third, highly individualized and constantly innovative. Based on the basic theory of TCM, with the deepening of the clinical experiences, the TCM doctors will summarize their own original experience and treatment methods in the clinical practice.[3],[5] These highly individualized and specific tacit knowledge are the source and essence for the innovation of TCM.[2] Last but not the least, difficult to explicate. TCM tacit knowledge is formed gradually on the basis of imagery thinking (象思维 Xiang thinking) along with TCM doctors' own experience and understanding.[3],[5] Although some TCM tacit knowledge could be described in imagery words, its specific meaning still needs to be deliberated by the inheritors. What's worse is that sometimes the meaning expressed in words is quite different from the original intention, which could mislead the inheritors easily.


  Existent Forms Of Traditional Chinese Medicine Tacit Knowledge Top


Existent forms of tacit knowledge

Tacit knowledge is always generated in the subtle and difficult to be realized and expressed, but easy to be overlooked. The possible existent forms of tacit knowledge are as follows:[6] (a) knowledge that subconsciously influenced by culture or region, which is similar to innate knowledge; (b) knowledge that could be perceived and stored into the long-term memory system but not be noticed by cognitive subject; (c) intentional knowledge which is not processed by language; and (d) the subjective judgments that the cognitive subject formed about the things but are ignored by the cognitive subject. Although these knowledge mentioned above have not been noticed by the cognitive subject, they all have a potential impact on the behavior of the cognitive subject and become their tacit knowledge. The TCM tacit knowledge is consistent with these situations.

Tacit knowledge in traditional Chinese Medicine theory

TCM belongs to natural philosophy. The TCM theory is based on the holistic concept, which means that harmony exists between human and nature, and the human body itself is a unified entirety. Therefore, the physiological and pathological manifestations appearing in the human body can also be explained by matching them with phenomena occurring in nature. TCM is dominated by imagery thinking; in other words, it is that the thinking of classification according to manifestation.[1],[3],[7] As Yi Jing (《易经》 Book of Changes) said that words cannot fully express all one's minds, the sage uses the image to express the meaning. The TCM theory expresses the physiology and pathology of the human body by applying the things or phenomena existing in nature. Such as the five elements (木、火、土、金、水 wood, fire, earth, metal, and water) are used to correspond to the five Zang organs (liver, heart, spleen, lung, and kidney), thus the characteristics of the five Zang organs could be expressed easily and visually. At the same time, the relationship between the five Zang organs both under the physiological and pathological conditions can also be well explained by the phenomenon of the five elements interacting with each other. Similarly, the four properties and the five flavors, as well as the meridian tropism, describe the property and efficacy of the Chinese herbal medicines well. All of them make the TCM theory much more understandable.

As the imagery thinking with the characteristics of tacit knowledge is the basis of TCM theory, in order to understand these imagery thinking adequately, it requires the inheritors to have sufficient cultural deposits, keen observation of nature, and a rich ability of imagery thinking.

Tacit knowledge in Traditional Chinese Medicine dialectical treatment

Different from the Western medicine, the basic treatment theory of TCM is dialectical treatment. In brief, all of the symptoms, signs, tongue manifestation, and pulse condition of each patient can be summarized as a syndrome. Then, the therapeutic methods will be made according to the overall analysis of the syndrome. Because of this, different therapeutic methods can be used to treat the same diseases, and the same therapeutic methods can also be used to treat different diseases. In this process, for the same disease in different patients, TCM doctors may give different syndromes according to their own experiences formed in the long-term practice. This makes the diagnosis of the symptoms highly specific. In addition, this is a strong proof that the tacit knowledge is integrated into the process of the dialectical treatment.

In the process of treatment, the importance of TCM tacit knowledge is extremely obvious. The usage of the treatment methods, including herbal medicine, acupuncture, cupping, and massage can also be different according to different TCM doctors. Each selected treatment method is also based on the individual knowledge and experience of TCM doctors. Further, for the usage of herbal medicines, much more tacit knowledge is included. Not only the prescription compatibility, but also the types and grams of the herbal medicines, all affect the therapeutic effect greatly. These tacit knowledge is gradually accumulated and passed down through varied methods. And, all of these are reflections of tacit knowledge in the dialectical treatment of TCM.

Tacit knowledge in traditional Chinese medicine writings

The tacit knowledge is integrated into every aspect of TCM theory and the ideology of TCM doctors. From earliest times to the present day, people are trying to summarize and inherit these highly individualized tacit knowledge by multiple ways. Medical books and medical cases are two common recording methods. Medical books can be not only the TCM doctors' understanding and annotation of other TCM classical books, but also a summary of the TCM doctors' personal experiences. These books are the gems of the authors' experiences, that is, the authors' tacit knowledge. Similarly, the medical cases in which the therapeutic effects have been confirmed are a comprehensive reflection of the TCM doctors' tacit knowledge in the treatment of diseases. Further, the TCM doctors' commentaries on the medical cases are much more precious, which could fully present the thinking of the doctors. Thus, the medical books and medical cases, compared to the experiences in oral, make much greater contributions to the inheritance of the TCM tacit knowledge.


  Inheritance Methods Of Traditional Chinese Medicine Tacit Knowledge Top


Master–apprentice inheritance and family-based inheritance

The master–apprentice inheritance and family-based inheritance are two common inheritance methods of TCM from the early times.[4],[8] The knowledge is mainly transmitted vertically from person to person. The inheritor could always stay with the master and be familiar with the cultural background, dialectical treatment methods, as well as the prescribing habits of the master. Therefore, this is advantageous to the inheritance of TCM tacit knowledge. However, the disadvantages are also obvious. The inheritance efficiency is low, and some characteristic treatments spread only within the master and apprentice or the family, which makes them easy to be lost or misunderstood. With the development of the time, this inheritance mode is less or only used as an auxiliary method of other inheritance methods.

School-based inheritance

Since the Northern and Southern dynasties (5th century AD) in China, beginning with the appointment of Taiyi medical instructor and the establishment of medical school, the school-based inheritance of TCM began. Up to now, the education of TCM tends to be systematized and large scaled gradually.[4] By this way, a large number of young TCM doctors with basic knowledge of TCM could be trained in a relatively short time. However, in order to make it easy to understand, the knowledge has been compiled and summarized from the classics, what the students learned is the most basic part of the TCM.[4],[5] It requires the students to have a better understanding; otherwise, the tacit knowledge in the classics is really difficult to inherit by this way.

Inheritance based on the books, images, and network platforms

Tacit knowledge is integrated into every aspect of TCM theory and the ideology of TCM doctors. Whether in the ancient or the modern times, compared to the experiences in oral, books are a comprehensive reflection of the TCM doctors' tacit knowledge in the treatment of diseases and play important roles in the inheritance of the knowledge. And, along with the spread of these books, the tacit knowledge contained in them can be inherited from generation to generation.

At present, with the development of science, more modern technologies have been applied to the inheritance of TCM tacit knowledge. Such as images, which could preserve the information in the most authentic state. This helps the inheritors understand the original meanings of the masters better, and also is good for the realization of tacit knowledge hidden in them. Further, through the application of some inheritance-related network platforms, the TCM doctors' experiences and medical cases can be systematically classified and sorted.[8],[9] The inheritors could have a comprehensive understanding of each doctor's thoughts. In addition, through the spread of the network, the inheritors will be greatly increased. However, it is difficult to communicate between masters and inheritors, and the questions arising in the learning process cannot be answered properly. Some deviations may happen during the inheritance of tacit knowledge.


  Mining Methods Of Traditional Chinese Medicine Tacit Knowledge In Modern Times Top


As the basis of TCM, tacit knowledge is a huge knowledge system implied in the theory and practice of TCM. As an important part of TCM modernization, in order to maintain the vitality and innovative development of TCM, it is urgent to explicate and inherit the tacit knowledge well and efficiently. By using the modern theoretical model and computer technology, some researches have explored the explicit methods of the TCM tacit knowledge from different aspects and here we made a brief summary.

SECI model

Socialization, externalization, combination, and internation (SECI) model was first proposed by the Japanese scholars Ikujiro Nonaka and Hirotaka Takeuchi, which is based on the Polanyi's theory of explicit knowledge and tacit knowledge. In combination with the practical situation of Japanese enterprise management, the SECI model puts forward a new understanding of knowledge creation and knowledge management. In their opinion, relying on the background of social communication, four stages are needed to complete a cycle of the transformation between tacit knowledge and explicit knowledge, which are socialization, externalization, combination, and internalization. By continuing every process of knowledge transformation, a spiral evolution model will be formed, which constitutes a continuous self-improvement and transcendence process. Some researchers have introduced SECI model into the inheritance of TCM and the study of imagery thinking, and they tried to seek a general application model about imagery thinking in order to make it widely used.[10] The SECI model also has been introduced into the management of TCM inheritance, which could come into the effects of improving teaching effect, promoting the inheritance and development of TCM knowledge and accelerating TCM cultivation of talents.[11]

Complexity adaptive system

Complexity adaptive system (CAS) was first presented by John Holland, a scholar of Santa Fe Institute. CAS is one of the important research contents and main research methods of the science of complexity. CAS is a system that can describe the overall changes caused by small adaptive changes of individuals. The basic idea of CAS is to regard the elements of the system as an agent with adaptability. Each agent can improve its structure and behavior by interacting with the environment of other agents. As a result, the whole system will evolve. Some researchers believe that during the process of dialectical treatment, the basic elements of TCM can be defined as agents, and the interaction among these agents will make a CAS during the TCM dialectical treatment. From this CAS, some attributes and rules can be summarized, which can further improve the CAS. This can also be used in the evaluation and optimization of dialectical treatment effects. The whole process then will be much more helpful for the research of TCM theory.[12] Furthermore, other researchers believe that the CAS can also be used in the hermeneutics of TCM classic literature, interactive expression in the inherited study, and knowledge “emergence” of individualized diagnosis and treatment in clinical practice. Moreover, these can be helpful in the explicit of TCM tacit knowledge.[13]

Latent variable model

The latent variable, which is opposed to observable variable, refers to unmeasurable and unobservable variables. Latent variable model is a kind of statistical analysis method, which has some specific classifications. As we know, TCM syndromes are concluded from the information of the four methods of diagnosis and with the characteristic of unmeasurable. Thus, the latent variable model can be used in the study of TCM syndromes and symptom factors extraction.[14] A summary of the application of the latent variable model in the TCM tacit knowledge mining is shown in [Table 1].
Table 1: Application of latent variable model in traditional Chinese medicine (TCM) tacit knowledge mining

Click here to view


Data mining technology

Data mining technology refers to the process of searching hidden information from large amounts of data through the application of specific algorithms. As mentioned above, the amount of TCM tacit knowledge is huge, and most of them are complicated. In recent years, the data mining technology has been widely used in the in-depth studying and mining of TCM tacit knowledge.[24] As shown in [Table 2], the application of some common data mining technologies in the mining of TCM tacit knowledge have been summarized [Table 2].
Table 2: Application of data mining technology in traditional Chinese medicine tacit knowledge mining

Click here to view



  Conclusion and Expectation Top


TCM is a treasure of traditional Chinese culture and a gift to the world. To fully explore, the TCM tacit knowledge is the key to its inheritance and development. Simultaneously, it is also an indispensable part of the TCM modernization. Nowadays, with the development of science and technology, some computational techniques have been applied to the mining of TCM tacit knowledge. Either in the analysis of the symptom factors and syndrome patterns, or in the exploration of the prescription compatibility regularity, people are trying their best to make the TCM tacit knowledge explicit and regularized from different aspects. However, it should be noticed that the most important thing to learn TCM is the communication between masters and inheritors, and most of the mining and inheritance methods cannot achieve this at present. Therefore, more intelligent methods should be introduced.

As one of the cutting-edge technologies in the 21th century, the artificial intelligence (AI) technology has been explored and used in the medical activities such as diagnosis and decision-making.[60],[61],[62] It is helpful to improve the patient care by speeding up process and achieving greater accuracy.[63],[64] Based on this, we believe that AI technology will also play meaningful roles on the mining and inheritance of TCM tacit knowledge. However, it is undeniable that considerable challenges will be came across, and the cooperation of the researchers from multidisciplinary and multi-domains are desperately needed. We believe that under the reasonable introduction of AI, the explicit and inheritance of TCM tacit knowledge will get tremendous development.

Financial support and sponsorship

National Key R&D Program of China (2017YFC1700301), the Fundamental Research Funds for the Central public welfare research institutes (ZZ13-024-4) and Qihuang Scholar of “Millions of Talents Project” (Qihuang Project) of Traditional Chinese Medicine Inheritance and Innovation to Feng-Qin Xu; and Beijing NOVA Program (Cross-discipline, Z191100001119014) to Yue Liu.

Conflicts of interest

There are no conflicts of interest.



 
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