Data and Facts The complexity of the human body, disease, and environment coupled with changes over time coupled and interacting with each other can generate massive amounts of data. It is easy to obtain this data in medicine, but difficult to analyze and interpret it correctly. This is because studying these data scientifically and relating them to human physiology and pathology has an inherently high degree of difficulty and complexity. At the macro level, with the introduction of medical testing technology, imaging technology and the improvement of hospital information technology, various test data, X-ray, ultrasound, CT and MRI images, tissue specimens, electronic health records, medical service records, etc. record various health-related information of each patient from all aspects. These vast and complex data provide information support and decision support for disease research and treatment from different perspectives, but they also bring endless problems and challenges to medical practitioners, especially clinicians. Medical practitioners must make comprehensive judgments and think carefully when using medical data to treat diseases or conduct research, because data may reflect facts or deviate from facts, thus misleading doctors’ judgments, mainly in the following aspects. 1, misjudge the cause and effect. When people analyze clinical epidemiological data, they usually regard some factors that occur before a disease as causative factors or even causes. Sometimes the same disease will be the lighter as the cause, the heavier as the result. However, this is not true from the perspective of medicine as a whole. In practice, some data make it difficult to clearly show which factors are predisposing and which factors are causing the disease, and often common sense leads to misjudgments. For example, the New England Journal published an article stating that there is a correlation between diabetes and pancreatic cancer. Common sense would lead us to arbitrarily conclude that it is diabetes that causes pancreatic cancer. But in fact, many of the diabetic patients in the data are recent onset, that is to say, they occurred after pancreatic cancer, and it is pancreatic cancer that caused diabetes, and it is pancreatic cancer that destroyed the insulin-producing pancreatic beta cells in the pancreas secondary to diabetes, so pancreatic cancer is the cause and diabetes is the effect. 2. Misbelief in pseudo-data. There are real data in the complicated medical data, but it also contains amplified data and even dirty data. These data mixed together can easily lead to results such as over-coincidence, pseudo-correlation and micro-positive. 2014 JAMA article, they compared published randomized clinical data with Meta-analysis and found that 35% of Meta-analysis reached conclusions different from those of the original research article, and these findings directly affect the evaluation of clinical trials. 3. Bias is sometimes present. There may be biases between the results of data analysis and facts, and these biases may be artificial or systematic. For example, someone found a high correlation between coffee drinking and the development of pancreatic cancer, which may be the cause of pancreatic cancer. However, in-depth analysis revealed that a large proportion of patients in the control group suffered from gastric ulcer and hardly drank coffee for fear of aggravation, so there was actually no relationship between the two. 4. Falsehoods are everywhere. Basic medical research is generating data faster and faster, and the data is getting bigger and bigger. When gene chips were first introduced, tens of thousands of gene expression levels or mutation sites could be measured in one experiment, and everyone used them to detect genes for lung cancer occurrence and metastasis, resulting in great disappointment worldwide. This proved to be an illusion under the genomics research boom. Relying on a single histological data cannot fully suggest the disease mechanism; it is necessary to combine multiple data to build a multifactorial analysis model in order to dig out the disease data at a more systemic level and thus give a reliable judgment. Evidence and experience Science is the description of various phenomena in the world and the summary of their changing laws. Scientific research is carried out by strictly controlling substances in certain space and under certain time conditions; therefore, scientific knowledge is universal, scientific method is objective, and scientific theory is rigorous. The pursuit of scientific research is most important is evidence, without evidence there is no and can not be a summary of scientific theories. In addition to the above requirements, medicine emphasizes more importantly the summation of experience in the process of interaction with different patients. This experience may lack the universality and even the rigor required by science because it varies from person to person, from place to place, and from time to time. Science emphasizes objective evidence, while medicine emphasizes, among other things, subjectively acquired experience. Thus, learning and practicing medicine according to the scientific approach is met with difficulties. Therefore, all experience developed so far varies from person to person, from place to place, and from time to time. Those who know the evidence do not necessarily have experience; those who have experience must know the evidence. 1. Gaining medical experience is harder than collecting evidence. Collecting evidence is the most important step for scientists to verify scientific hypotheses. But it is not so easy to gain medical experience. Doctors have to make preliminary judgment on the cause of the disease through long-term observation or repeated communication with the patient; then they can trace the traces of the disease by looking, smelling, feeling or seeing, touching and listening to the patient; then they can corroborate their judgment by examining certain medical equipment; then they can evaluate the treatment effect by trying to use drugs for the disease and observing the patient’s reaction. 2. It is harder to organize medical experience than to analyze evidence. It takes at least 11 years to train an MD in China, which is significantly longer than students of other majors, while training an excellent doctor requires permanent learning and accumulation of experience after graduation. Medical experience comes from doctors’ communication with patients and their own summaries. It is difficult enough to record one’s work or experience, and it is even more difficult to organize one’s experience into a law so that others can learn from it. 3. The application of medical experience is more difficult than the application of evidence. In scientific research, the scientific evidence collected at hand is summarized and the scientific laws obtained can be applied to any similar things. But in medical research, whether or how the summarized medical experience can be applied to other patients is a headache for doctors. Can a drug that works for most patients be applied to all people with the same disease? The answer is no. For example, cetuximab, a tumor-targeting drug developed in recent years, can bind to EGF receptor, thus inhibiting tyrosine kinase (TK) and blocking intracellular signaling pathway, which can be used together with chemotherapy drugs to improve the treatment effect of colon cancer. Unfortunately, it is effective for only 22.9% of patients, and not only ineffective for nearly 80% of patients, but also increase the economic burden if used blindly. 4. Evidence-based medicine can produce experience but it does not necessarily work. Evidence-based medicine as a scientific method is beyond reproach, but its introduction into medicine has caused many problems. The core of evidence-based medicine relies on evidence, but this evidence is obtained by different doctors from different patients in different places and at different times, although there are random methods to correct it, in fact it is difficult to ensure the uniformity or balance of the evidence taken. If these inconsistent pieces of evidence are added together and percentages are used to arrive at a result that is hardly the experience of the physician. Experience is very important to medicine, and following it is currently the primary method of medical problem solving. If humans were to rely solely on evidence to overcome disease, far fewer diseases would currently be cured. In medicine, so many empirical things are still unclear, but effective and useful, and this is the difference between medicine and science. Cause and effect vs. correlation Science usually emphasizes the cause and effect relationship of things, while medicine is highly concerned with cause and effect relationship and at the same time emphasizes correlation relationship. In medical practice, the two types of relationships, cause-effect and correlation, are difficult to distinguish from each other and can be easily confused. Generally speaking, correlation includes causality, but correlation is never causality. In medical practice, there are indeed many cause-effect relationships, but it is the correlation relationship that exists the most. For example, in textbooks, almost every disease lists several or even more than ten causes. Originally, a disease, if the cause is clear, should have only 1 to 2 kinds of causal relationships. Why are more than 10 kinds listed? In fact, many are correlations. However, as the research progresses, some correlations may be identified as causal; some will be excluded; and some correlations will be included again and again. However, due to the complexity of medicine and the limited cognitive abilities of individuals, it is easy and sometimes tempting to see correlations as causal. There may be causal relationships in medicine, but they are not always transmissible. Both causality and correlation are connections between factors in things. In terms of medicine, causality is local, correlation is holistic; causality is direct, correlation is indirect; causality is temporary, correlation is long-term; causality is narrow, correlation is broad. It is easier to deal with causality in medical research and medical practice, because it is real and targeted. But dealing with correlation is difficult, because it is a target that is unclear and foggy. Treating the disease is dealing with the cause-effect relationship and getting the patient well. And dealing with the correlation can strengthen health care, so that healthy people do not get sick, less sick, or get sick light; dealing with the correlation can also accelerate recovery, so that the patient is cured as soon as possible to restore health, or completely restore health. Science and ethics Science is generally not influenced and limited by other factors, except for considering its own impact on other fields or even harm. However, the object of medical research is human beings, who have social and thinking attributes in addition to their natural attributes. In other words, the object of scientific research is static (a fixed non-living body) and homogeneous, while the object of medical research is dynamic (a living being) and complex, and it does not allow any obvious harm or even disability to it, whether physical or psychological. Therefore, it must be oriented and constrained by ethical norms. Any experiment in humans must be approved by an ethics committee before it can be performed. Science often encounters a double-edged sword and at the same time is seen as such. The progress of science, on the one hand, has brought great help to human civilization, such as increased food production, more eggs and meat, and longer life expectancy; on the other hand, it has brought great challenges and even hazards to human civilization, such as a surge in coronary heart disease and diabetes due to overnutrition. The progress of medicine itself is also full of contradictions between science and ethics. It is manifested in the fact that something is scientifically strict and correct and satisfies the requirements of science, but ethically unworkable, or even cruel from the humanitarian point of view; something is scientifically qualified, but ethically unreasonable, and is then medically illegitimate. Therefore, it is difficult to be a doctor and even more difficult to be a distinguished doctor. Their innovations are subject to ethical influences, to strict restrictions by ethics committees, which are almost to the point of being harsh, and they are also subject to national pharmacovigilance or laws, and even to religious theology. Theory and Practice The interplay of theory and practice is an integral part of the development of medicine and a process that medical practice must undergo. The practice of medicine must be guided by correct theory, and the correctness of theory must be tested by practice. Medicine places special emphasis on practice, arguably more so than any other science. Medical theory is formed from clinical practice, and it represents the basic laws of the human body, which can be used to guide practice and has universal significance. However, medical theory is by no means universally valid for medical practice. The difficulty of medicine is usually manifested in the diagnostic management of individuals or diseases that deviate from these basic laws, and this can often reveal differences in the level of clinicians. Observation and mastery of general laws can be used to form consensus or guidelines. However, the latter is only a basic requirement or common sense, which is only useful for general primary care doctors or young doctors on the front line. However, those who come to big hospitals are usually small hospitals or young doctors who have been treated with general guidelines and not cured, that is, cases screened out by the guidelines, and if we still use the general guidelines to repeat the treatment, the effect is definitely not good. These cases are outside the guidelines, and we can call them exceptional cases, which are also the most accidental cases. This requires us to use more advanced experimental attempts and unique experience to solve patients’ problems, and then form new guidelines, more suitable for difficult patients, and then promote them. In fact, medicine differs from science in more than these 17 aspects, for example, there are appearance and substance, cure and self-healing? etc. So the idea that medicine is science is something that I strongly oppose. The great advances in science have pushed science to a supreme position, leading to the emergence of scientism. However, since medicine has put on the hat of science, in fact, so many problems not only cannot be solved, but also lead to the alienation of medicine from people, and even more and more distant. It is this universal knowledge and concept that has led to the embarrassing situation of medical practice nowadays: we are not only explaining medicine with scientific theories, studying medicine with scientific methods, demanding medicine with scientific standards, but also passing on medicine with scientific laws. As a result, the essence of medicine will be modified by science; the characteristics of medicine will be transformed by science; complex medicine will be replaced by simple science; medical workers will become scientific researchers; medical schools will become academies of science; patients will no longer be the people that doctors care for but will become the objects of scientists’ experimental research. This will be an unacceptable and even unbearable fact. This is neither the original purpose of the origin of medicine, nor the purpose of medical development. In view of this, I think the future medical practice, including medical education, should pay great attention to the following issues. 1. Use scientific theories to help medicine, but not to bind medicine with them. Theories of science are the universal laws of various things in the world and have their universality. The human body exists in the world, is a part of the world, of course, also subject to the norms and influence of this universal law. But this is not quite true, if the theory of scientific discovery rigidly into the medical system, will certainly affect medical research and medical practice, either misleading or binding. 2, the use of scientific methods to study medicine, but can not be used to misunderstand medicine. By applying scientific research methods, or scientific calculation methods, we have solved many medical mysteries and greatly promoted the progress of medicine. However, in history, due to the improper application of scientific research methods or improper interpretation of their results, or more often due to the limitations of scientific research methods or calculation methods, there have been many inter-medical jokes and even serious consequences. Because the results observed by the scientific method are mostly individual, in vitro, structural, microscopic? While the actual situation encountered in medical practice is group, in vivo, functional, macroscopic? The two are far apart. 3, the use of scientific data (or technology) to help diagnose disease, but can not be used to replace the doctor. The two most remarkable aspects of the development of clinical medicine in recent decades are the results of science or basic medicine used in the clinical field: one is laboratory medicine; one is imaging medicine. One from the cell deep into the molecular genes; one from the one-dimensional development to the four-dimensional image, so that the level of medical diagnosis greatly improved. But at the same time, it has triggered a large number of young doctors who are difficult to suppress their dependence, which seriously affects the training of high-level medical talents. 4, the use of scientific consensus to form guidelines, but can not be used to generalize. It should be said that all therapies, or all drugs are researched by scientific methods, and their efficacy is calculated by scientific methods, but never all therapies or all drugs are effective for all people. Because we treat patients with scientific therapies, judging the efficacy is mostly based on data, evidence, cause and effect, inevitability? whereas the reality of medical practice is based on facts, experience, correlation, and chance? The two are far apart. Therefore, we should not be overly superstitious about the guidelines developed by the scientific method, and we should not generalize. Conclusion Medicine and science belong to two different “paradigms” (Paradigm), which are incommensurable. Science defines a world view and a view of nature, while medicine defines a view of life and health. Science needs to “look up at the universe and look down at the reasoning of categories”; medicine needs to “look at the flourishing of human beings and search for solutions to diseases”. Some practices of medicine are not necessarily scientific, but as long as life is still alive, health is still alive. The two are equivalent to two trains running on the road, one cannot cover the other, and one cannot replace the other. Although they sometimes intersect, after passing through the intersection or junction zone they need to continue to run in their respective directions, ultimately reaching a common goal – to serve the interests of humanity. However, because the two tracks differ in width and material, the trains use different power modes and different speeds, thus they need to go their own way, not to exchange, and not to retrace their steps on a single track, otherwise they will not reach the common ultimate goal. Since medicine is special and complex, it is neither like a pure science, but it is inseparable from science. So what is their relationship? Personally, I think it is like the relationship between parachute and skydiver. Science is like a parachute canopy, medicine is like a parachutist, how can we achieve a safe landing? ① first to open the parachute cover, give full play to the buoyancy brought about by the area of the parachute cover, can not open hold into a ball will fall to death; ② parachute cover open, all parts to grab, that can not grab over, but also unnecessary, but grab less, only grab a part will also be fallen to death; ③ successful landing is the most important is the 17 ropes, just like the 17 relationships I talked about in the previous. These 17 ropes connect and link the parachute cover with the jumper, and finally land safely. Recently, we have been advocating integrative medicine, called Holistic Integrative Medicine (HIM), which is like these 17 strings, linking the individual and the group, the local and the whole, the instant and the long-term, the physical and the psychological? These 17 relationships, along with the vast amount of data and knowledge discovered by science so far, are selectively and organically integrated into a new medical knowledge system for the needs of the whole, and used in medical practice. I have repeatedly said in four articles, “Integrative Medicine,” “Integrative Medicine,” “Integrative Medicine,” “Integrative Medicine,” and “Holistic Integrative Medicine” that “integrative medicine requires us to integrate not only the known biological factors, but also the psychological, social, and environmental factors. Integrative medicine requires us to integrate not only the most advanced scientific discoveries in life related fields, but also the most effective clinical experiences in all medical specialties. We need to consider problems not only with the unitary thinking of the natural sciences, which is expressed linearly, but also with the pluralistic thinking of philosophy, which is expressed non-linearly. “Through this upgrading of unitary thinking to pluralistic thinking, and through the reintegration of these four integrations, a new medical knowledge system can be constructed that is more comprehensive, systematic, rational, in line with the laws of life, and more suitable for human health maintenance and disease diagnosis, treatment and prevention. Ultimately, the health of human beings can be truly guaranteed and safeguarded, and then truly “know ourselves”, which is what this paper and I think, think and wish.