Introduction
Integration is both the current trend and most effective solution to the thorny problems of the modern era. The long history and rapid advancement of medicine have resulted in substantial contributions to human health. However, medicine has encountered unprecedented problems associated with changes in nature, society, and environment, as well as with new human quests for survival, longevity, and health. The development of medicine is currently facing challenges because of the over-division and over-specialization of medical disciplines and the fragmentation of medical knowledge. Roy Porter, a medical historian, stated in
The Cambridge Illustrated History of Medicine in 2000, “Never have people in the West lived so long, or been so healthy, and never have medical achievements been so great. Yet, paradoxically, rarely has medicine drawn such intense doubts and disapproval as today.” [
1] Therefore, we should seriously consider the direction and path for the future development of medicine while reflecting on the history of medical development. Therefore, the concept of holistic integrative medicine (HIM) has been proposed and put in practice [
2].
History of medical development
The long history of medical development can be symbolized by the shape of two N’s. The first “N” refers to the trend that medical advancement followed. Medicine advanced during primitive society, plateaued during the Middle Ages, and then declined until it rebounded. Both Western medicine and traditional Chinese medicine (TCM) exhibited this developmental pattern, with the turning points of TCM occurring later than those of Western medicine [
3]. The second “N” stands for the pattern of medical development, which began as the integration of both knowledge and experience that gradually formed the primitive medical knowledge system, followed by gradual differentiation and specialization, and the emergence of integrative approaches in medicine [
4].
The wavelike development of medicine can be roughly divided into three stages.
The first stage is the era of empirical or traditional medicine. In primitive society, people suffered, and even died, from wounds and diseases. In their struggle with nature, they gradually accumulated many valuable and effective methods for disease prevention and treatment, including medicine, pharmacology, and psychology. During this stage, medicine referred to all knowledge relevant to mankind. However, in today’s society, modern medicine specifically refers to the knowledge associated only with human body and life. The book The Yellow Emperor’s Classic of Internal Medicine is a good example that illustrates primitive medicine. Only 30% to 40% of its content can be categorized as medicine on the basis of the modern definition. The rest of the book’s content belongs to philosophy, sociology, psychology, and other environment- and nature-related disciplines. At this stage, different nationalities, regions, and cultures have developed their own distinctive medical systems. In addition to Western medicine, many alternative medical systems have developed around the world, including TCM, acupuncture, traditional medicine, folk medicine, meditation therapy, hypnosis, homeopathy, massage therapy, aromatherapy, diet therapy, vitamin therapy, spa therapy, and oxygen therapy. Various diseases were diagnosed with these medical systems, which had different perspectives and methods and were proven to be reasonable, effective, and advanced in their respective times. However, most of these medical systems gradually disappeared because of external reasons, such as the rise of theology, the prevalence of religion, political oppression, economic exploitation, armed invasion, and even violent repression, as well as internal reasons within the medical systems themselves. One example is China. In addition to classic TCM, Tibetan, Hui, Uygur, Korean, and Mongolian medical approaches also developed in China. However, only the founding of the People’s Republic of China and the strong support of the government leaders allowed TCM to survive.
The second stage is the era of scientific medicine or biomedicine. Western medicine was initially underdeveloped but rapidly advanced with the introduction of scientific methods. The invention of the microscope by Leeuwenhoek and the integration of chemistry, physics, mathematics, and biology extended Western medicine’s reach from the macro-level to the micro-level. Many incurable diseases became curable when the previously unknown etiologies of many diseases were identified. Western medicine has gradually dominated all other medical systems. However, its narcissistic single-flower show or single-direction development has caused problems. For example, more than 90% of the 4000 common diseases that afflict humans cannot be effectively treated with available drugs. In addition, more than 99% of the 7000 rare diseases that afflict humans are currently incurable. Malignancies have become one of the four most common causes of human death, and their treatment is ineffective in most cases. Various medical models have been successively established; for example, evidence-based medicine has been replaced by translational medicine, which was then replaced by precision medicine. Although all of these medical models have played a positive role, their intrinsic weakness lies in their attempts to approach the grand and complex problem of human health from a singular and narrow angle. The nature of human health and diseases has profoundly shifted from (1) infectious to noninfectious (chronic disease), (2) malnutrition-related to over-nutrition-related, (3) hebiatric to geriatric, (4) organism-caused to environment-/society-associated, (5) single-cause to multicause, (6) simple to complex, (7) early-lesion to late-lesion, (8) single-organ to multiple-organ, (9) organic to functional, and (10) emergent care and life preservation to disease prevention, rehabilitation, and life expectancy improvement strategies. Therefore, we must use novel strategies and approaches to cope with these profound changes. The scientific development of medicine on a contemporary and international scope should include national realities and personal conditions and should never sacrifice fundamental humanity. To keep medical development in the right direction, we should pay attention not only to science or biology but also to sociology, psychology, and humanities. We must integrate all aspects of human knowledge that are beneficial and useful to human health into the studies of medicine [
5].
The third stage is the HIM era. Our limited medical knowledge in the past has greatly increased through a wealth of medical research in the present era of explosive medical advancement. We have accumulated substantial clinical experience through the treatment of numerous patients. We have discovered many effective methods for disease prevention and acquired significant knowledge on health rehabilitation through steady summation and improvement, which has provided a golden opportunity to establish a new medical knowledge system through collection, collation, and integration [
6]. Meanwhile, the complexity and variation of diseases remind us that it is impossible to solve fundamental medical problems with any single discipline of knowledge or piece of technology. Therefore, we should integrate existing knowledge and technologies related to the human body to establish a new medical knowledge system that is better suited to the improvement of human health.
Connotation of HIM
To construct a new medical system more suitable for human health and disease treatment, HIM regards the human body as a holistic entity; organically integrates the most advanced knowledge and theories in each medical field and the most effective practices in various clinical specialties; and develops corresponding revisions and adjustments according to social, environmental, and psychological conditions [
7]. HIM is the inevitable and necessary direction for the future development of medicine. The theoretical framework of HIM includes at least the following three aspects.
Holism
The human body is a holistic and living entity. Therefore, (1) it is difficult for an individual to represent a population; (2) it is difficult for the
in vitro to reflect the
in vivo; (3) the internal and external environments of the human body are vastly different; (4) structure is not equal to function; (5) the sum of the parts is not equivalent to the whole; (6) it is difficult for the micro to represent the macro; (7) the static and the dynamic are different; (8) there are differences between instant results and long-term outcomes; (9) the relevance of indirect factors is not the same as that of the direct ones; (10) science involves inevitability, whereas medical science often involves contingency; (11) there is a misalignment between physiology and psychology; (12) the objective is not always consistent with the subjective; (13) data and facts are different; (14) evidence and experience can be dissociated; (15) causality is different from correlation; (16) science may conflict with ethics; and (17) theory can be divorced from practice [
5]. Therefore, we should not simply regard local, instantaneous, and directly observed phenomena as the whole situation. In addition, we should not regard any variant data and indicators as diseases, nor should we consider all diseases as harmful to the human body. We should make a thorough observation and comprehensive assessment. A patient should be regarded as a person with a disease instead of a disease in a person. Therefore, doctors should treat the person with the disease rather than focus on the disease itself.
Integration
Integration means that all the existing knowledge and experience related to the human body are collected and collated. Then, these pieces of information are optimized and ultimately integrated into a new medical knowledge system that is more suitable for disease diagnosis and treatment and human health rehabilitation. The concept of integration comes from a holistic and people-oriented perspective. Integration aims to (1) focus on patients instead of organs; (2) focus on diseases instead of symptoms; (3) include everything from tests to clinics; (4) include everyone, from pharmacists to physicians; (5) emphasize both physical and mental health; (6) emphasize the work of both doctors and nurses; (7) emphasize both Western medicine and TCM; and (8) emphasize both prevention and treatment [
4,
6]. Over-specialized medicine, over-divided medical disciplines, and fragmented medical knowledge need to be rectified. HIM is essentially not a regression but a development and progression of medicine in a new historical period. Integration should cover both existing known biological factors and psychological, social, and environmental factors; both the most advanced medical discoveries in various fields related to life and the most useful clinical experiences in various specialties associated with medicine; and both one-dimensional thinking of linear relations in natural sciences and multivariate, nonlinear, and philosophical thinking. Establishing a new medical knowledge system that is more comprehensive, systemic, rational, in line with natural law, and suitable for human health maintenance, disease diagnosis, treatment, and prevention is possible with the transition from one-dimensional to multidimensional thinking and the reincorporation of the four integration processes [
7]. Integration is different from mixing, fusing, matching, connecting, and combining. Mixing is disordered, fusing is passive, matching involves priorities, connecting is conditional, and combining is limited by objectives: these actions are confined by rules and rarely go beyond expectations. However, integration is orderly and active, does not discriminate between the primary and the secondary, and is unconditional. The outcome of integration can be vividly described with the Chinese proverb “Blue comes from the indigo plant but is bluer than the plant itself.”
Integration has at least three levels. The first level is associative integration. Associative integration aims to form a line to associate various related factors. It shows a hierarchy of ranks in horizontal or vertical forms, with the adjacent ranks clearly exhibiting causal, temporal, and primary and secondary relations. The following examples show an incremental or progressive relationship and vice versa: molecule → cell → tissue → organ → system → whole body or symptom → sign → examination → diagnosis → treatment → prevention. This is the most common and simplest integration, which can be used to solve common and simple issues. This is the scenario in which a resident doctor or doctor in charge deals with the majority of medical problems in clinical practices.
The second level is parallel integration. It aims to align various results of associative integration to create a new whole integration for the analysis of relationships among internal horizontal or vertical forms. Compared with associative integration, parallel integration involves more factors, contains more complex relationships, and requires more comprehensive understanding. It generates a sense of dimension, which not only shows the relationship between two adjacent factors but also reflects the causal, temporal, and primary and secondary relations among more adjacent factors in all respects, such as digestive system ↔ respiratory system ↔ circulatory system ↔ blood system ↔ endocrine system. More difficult and complex problems can be solved on this level. In clinical practice, it is used by experienced experts to deal with thorny cases.
The third level is overlapping integration. Several two-dimensional systems are formed through overlapping parallel integration to create a multidimensional macro-system, which includes a large or even infinite number of factors that may substantially change. An unlimited number of factors may instantly cause considerable changes, which also reflects the nature and characteristics of the human body as a whole. Moreover, various horizontal and vertical factors are neither necessarily sequential nor correlated. Instead, indirect, nonlinear, or crossover relationships may exist among these factors, and adjacent factors may not be directly related to each other. The relationships among factors may not be explicit, so it is difficult to distinguish the causal, temporal, and primary and secondary relations at times. In addition, mutual relationships may also change with time and with deep-rooted, complex, and even chaotic states presented. Their interactions are multidirectional, interdependent, and intertwined. The highest level of integration is overlapping integration. It can be envisioned as a complex building made of not only steel and cement but also wood and nails, having both lateral and vertical connections. Complicated, critical, and severe cases in clinical practice usually require the consultation of many experts from different disciplines, in which associative, parallel, and overlapping relationships intertwine with one another. The diagnosis is made often with the assistance of computers or statistical experts, with or without success.
Associative integration only requires logical thinking, which is intuitive and straightforward, whereas parallel integration requires abstract thinking. Overlapping integration requires holistic thinking. These three models of integration coexist in medical practice. When a clinician examines the symptoms, signs, and test data of a patient with a complex and severe disease, he/she will soon imagine the outcome of the treatment by thinking of associative or parallel integration. Additionally, the physician’s holistic thinking plays an important role in the rescuing and saving of the patient’s life.
Perspective of medicine
Medicine is a very complex body of knowledge and is neither equal to pure science nor to pure philosophy. It is closely related with not only science and philosophy but also sociology, anthropology, psychology, law, economics, and art. Therefore, any discipline related to the human body is relevant to medicine. Science is only a component of medicine. The possibility of scientific research to obtain substantial findings is either 100% or 0%, whereas that of medical research findings ranges between 0% and 100%; that is, nothing is impossible. In scientific research, any outcome leads to a conclusion, regardless of its usefulness in the short or long term. The outcome of clinical application is more important than the results and conclusions obtained from medical research because they are pointless without successful application. Therefore, we suggest the following: (1) scientific theories should be applied to enhance rather than limit the development of medicine; (2) scientific methods should be used to study rather than mislead medicine; (3) scientific data should be used to assist diagnosis rather than replace doctors; and (4) scientific approaches should be used to formulate practical guidelines rather than encourage bias or prejudice [
8].
From the holistic, integrative, and medical perspectives, HIM regards the human body as a whole, turns data and evidence in medical research back to facts, transforms knowledge acquired from clinical practice into experience, and integrates technologies and arts developed in clinical research into medical skills. The repeated practices at the levels of fact, experience, and medical skills will generate true knowledge, which is HIM. HIM is not a concrete medical system. Strictly speaking, it is both an epistemology and a methodology, and the implementation of HIM is expected to lead to the creation of a new medical knowledge system.
Creating a new medical knowledge system is like building the Great Wall of China, which maintains peace from within and resist enemies from the outside, similar to the role of medicine in human health. The magnificent Great Wall of China stretches for thousands of miles. The construction of the Great Wall of China depends merely on three important and indispensable factors: template, adhesive, and brick. HIM aims to build a new “Great Wall” to maintain human health, with holistic, integrative, and medical factors equivalent to template, adhesive, and brick, respectively. Given that these three factors are equally important, overemphasizing any of them will lead to the failure in the construction of the new “Great Wall.” The integration process is complex owing to the fact that nature, human body, society, and medical knowledge are constantly changing. Therefore, as a methodology, HIM will be a permanent topic in the development of medicine.
Differences
Similar concepts to HIM emerged at the domestic and international levels simultaneously or prior to its proposal. However, HIM has its own distinctive features.
Holistic medicine
Holistic medicine emphasizes human wholeness and the combination of the human mind, body, and spirit. It is dangerous, however, to attach too much importance to the effect of external psychological and social factors to the human body and to consider trivial things as main medical factors [
9], which is akin to collecting many parts of an airplane and piling them up. HIM not only collects the essential parts directly related to an airplane but also integrates them into an airworthy aircraft.
Integrative medicine
Integrative medicine (IM) and HIM share the same Chinese term. However, these two systems have completely different connotations. IM uses non-mainstream medical knowledge or technologies as complementary or alternative approaches to mainstream Western medicine, such as acupuncture, massage from TCM, meditation therapy, hypnotherapy, aromatherapy, spa therapy, and thermalism. Therefore, IM is also known as complementary or alternative medicine [
10]. IM is similar to stitching patches on an old coat to make superficial changes in form but not in nature. By contrast, HIM is akin to making a new coat with a brand new piece of cotton fabric, thus performing a fundamental and essential change.
TCM
TCM emphasizes the unity not only of the human body but also between man and nature and between man and the social environment. TCM regards the human body as a whole with inseparable structures, coordinative functions, and interactive pathologies. TCM believes that local pathological changes can be managed by adjusting the whole body; this theory is within the framework of holistic medical thinking [
11]. However, a significant number of black boxes between its theory and practice exist, with many of its grand ideas and hypotheses unconfirmed by scientific research. By contrast, HIM not only regards the human body as a whole but also integrates existing medical knowledge and technologies. The process of house construction is a good symbol when comparing TCM with HIM. TCM serves as the blueprint, whereas HIM is responsible for building the house from various building materials on the basis of the blueprint.
General practice
General practice emphasizes that a general practitioner must master various basic skills and multidisciplinary knowledge or technologies. However, each skill is simply added to improve the physician’s competence, resulting in a model for general education that is based on existing theories and practices. By contrast, HIM integrates the most advanced knowledge and technologies of various disciplines to establish a new system of medical knowledge that aims to dramatically increase the physicians’ competence; this system adapts the method of multiplication [
7]. General practice is like a mixed pot of dishes, whereas HIM is a refined dish. The former is nothing but a mixture and the latter is characterized by its delicate raw material, ingredient preparations, and cooking procedure. General practice resolves common problems, whereas HIM deals with incurable problems. Therefore, HIM will guide and promote the development of general practice.
Multiple-discipline therapy
Multiple-discipline therapy (MDT) is very similar to general practice. When an extremely complicated case cannot be resolved by a single discipline, MDT consults with multidisciplinary experts to develop a comprehensive and appropriate therapeutic regimen that is used to weigh treatment merits and demerits, improve therapeutic effect, and reduce side effects. MDT suggests a combination and compromise of current medical practice. MDT is like huddling together for warmth [
12], whereas HIM aims to increase the room temperature.
“IM”
Integrative therapy, also referred to as IM, was recently proposed because of the poor therapeutic effects of existing regimens on advanced malignant tumors. Integrative therapy includes surgery, chemotherapy, radiotherapy, immunotherapy, and TCM. IM is a comprehensive treatment strategy that is equivalent to MDT. HIM does not focus on a specific therapy because of its comprehensive nature, and is an epistemology and methodology for the establishment of a new medical knowledge system. The term “holistic” in HIM has two meanings: entirety and integration. In addition, “integrative” in HIM has two meanings: the establishment of a new medical knowledge system through integration for the better maintenance of human health and the effective treatment of diseases. “IM” is like a loosely organized group without optimization, whereas HIM is like a well-organized team with optimization. Sharp differences in both objectives and fighting capacities exist between IM and HIM.
Evidence-based medicine
Evidence is the cornerstone of evidence-based medicine (EBM) and following the evidence is the essence of EBM [
13]. However, whether an “objective” piece of evidence reflects the truth depends on sample size and when and how the evidence is obtained. Although a single piece of evidence does not represent the whole, too much evidence may make it difficult to analyze results. Moreover, even the same disease may manifest different symptoms in different patients and may change with time. Therefore, the substantial amount of evidence and data should be screened to reveal facts. The HIM knowledge system can be ultimately developed and established by transforming recognized knowledge into experience, integrating technologies and arts into medical skills, and then practicing HIM at the factual, empirical, and medical levels.
Translational medicine
Translational medicine aims to transform findings in basic research into programs or products necessary to clinical diagnosis and treatment, as well as emphasizes a seamless bench-to-bedside process [
14]. Although translational medicine has been implemented for 17 years, little progress has been made in this field because the vast majority of results in basic research was not applicable to clinical practice and was even misleading in some worst cases. In addition, many clinical practices, although effective, could not be explained by a single basic theory. HIM stresses clinical applications and their efficiency, although it also advocates the integration of basic research into clinical practice. It encourages basic theoretical research and the applications of research findings in clinical practices in a benign cycle of iterations. Therefore, translational medicine often provides an uncooked meal, whereas HIM provides a cooked one.
Precision medicine
Although precision medicine appears tempting, it deviates from the essence of medicine. Precision medicine utilizes methods, such as DNA sequencing or genomics, to search for data and evidence in the human body at the micro-level and attempts to identify previously undiscovered evidence with big data [
15]. HIM does not oppose research at a micro-level, but it approaches problems from a macro-perspective and views the human body as a whole. The discovery of specific molecules in a patient is not a guarantee that his/her pathological disease and its associated changes will be cured and that his/her body will recover. Precision medicine is similar to catching a thief by following a similar principle reflected in the old Chinese saying “capture the ringleader first to capture all the followers.” By contrast, HIM pursues peace and harmony in the world from holistic and comprehensive perspectives.
Practice of HIM
HIM has received prompt attention from local and international medical experts although it was proposed only recently. Many pioneering HIM practices have been conducted in medical fields.
Established HIM academic organizations
Three national HIM academic organizations have been established: the HIM Committee of the Chinese Society of Research-Oriented Hospitals, HIM Committee of the Chinese Medical Association, and HIM Branch of Digestive Diseases of the Traditional Chinese Medicine Association. In addition, the HIM Committee of the Chinese Medical Association, the HIM Committee of the Chinese Preventive Medicine Association, the HIM Branch of the Chinese Anti-Aging Association and HIM Oncology Branch of the Chinese Anti-Cancer Association are currently being organized.
Established HIM research centers
A total of 105 HIM research centers have been established in 27 provinces in China. Each center conducts collaborative research on a difficult medical problem of interest. For example, the Xijing Hospital of Digestive Diseases has created the Drug Rational Use Guideline System (DRUGS) to solve existing problems regarding the reasonable use of drugs; this system has been applied in more than 90 hospitals in China and has achieved good results [
16].
Convened HIM academic conferences
More than 20 national HIM conferences have been held thus far, including the first Chinese Congress of HIM, the first HIM session of the Chinese Society of Research-Oriented Hospitals (Xinjiang); the first, second, and third Chinese Integrative Cardiology symposiums; and the first, second, and third Chinese Integrative Digestive Diseases Through Combining Western Medicine and TCM symposiums. The author of this article has been invited to give reports on HIM at 81 national academic conferences sponsored by 87 national medical associations and at more than 100 medical universities in China.
Published HIM journals
Negative is a comprehensive journal that mainly advocates for HIM with a total distribution of 39 issues in 7 volumes. It was formerly known as
Journal of the Fourth Military Medical University with only 400 subscriptions. The number of subscriptions to
Negative has reached 140 000 since its initial publication. Some feature articles and special columns on HIM have been published in
The Chinese Journal of Digestion [
17],
The Chinese Journal of Hepatology [
18],
The Chinese Journal of Internal Medicine [
19],
The Chinese Journal of Endocrinology and Metabolism [
20], and
National Medical Journal of China [
21].
Published HIM monographs
Currently, more than 20 books on HIM have been compiled and published, such as Holistic Integrative Hepatoenterology [
22], Holistic Integrative Ophthalmology [
23], Holistic Integrative Pancreatic Oncology [
24], Holistic Integrative Colorectal Oncology [
25], and Holistic Integrative Medicine—Theory and Practice [
26].
Published series of HIM textbooks
A series of electronic textbooks for use in medical universities have been compiled by 60 editors-in-chief, more than 300 deputy editors, and more than 3000 editorial board members. Compared with the original printed version, these electronic HIM textbooks contain an additional 20 million words, 10-fold photos, and up to 200 hours of audio materials. The textbooks also contain both static and multimedia content and are currently in trial use at more than 60 medical universities with good feedback [
27].
Established HIM wards
HIM wards have been established in many hospitals in China. Eight affiliated hospitals with the Fourth Military Medical University have been established, with relevant disciplines as digestive internal and surgical medicine, cardiac internal and surgical medicine, and neuronal internal and surgical medicine integrated into one building to share resources and train talents. HIM wards have achieved good results. A more advanced HIM ward has been established in the Xijing Hospital of Digestive Diseases, which has been ranked first among the national professional disciplines for seven consecutive years [
28].
Public recognition
The concept and practice of HIM have attracted wide attention from both societal and medical circles. The article entitled “Holistic integrative medicine” was published in its entirety of 15 pages in
American Journal of Digestive Disease (Issue 1, Volume 1) in 2014 [
2]. Nine articles with a total of more than 500 000 words have been published in their entirety or as excerpts in more than 20 newspapers, magazines, and websites in China. These articles are “Advance and retreat of life science in three thousand years” [
3], “Medicine and science” [
8], “More reflection on medicine and science” [
5], “Preliminary reflection on holistic integrative medicine” [
7], “More reflection on holistic integrative medicine” [
6], “On holistic integrative medicine” [
4], “Integrative lessons for pharmacologists and physicians” [
16], “Health care reform through addition, subtraction, multiplication, and division” [
27] and “Strategy of top quality improvement and discipline construction” [
28]. A column titled “Academician Fan Daiming on holistic integrative medicine” has been published in the newspaper
Physician Online consecutively for the past two years, with 101 series published in 101 issues. It has also received positive comments, with a large number of its readers engaged in heated discussion.
Conclusions
Yizhuan stated that what is metaphysical is Dao and what is physical is a tool. In my opinion, Dao refers to philosophy and tool refers to science. I believe that medicine is in a chaotic state between the metaphysical and physical domains: reaching up for Dao and reaching down for a tool. Our patients approach us every day with numerous symptoms because of various factors. If we only utilize shallow logical thinking, we may find countless causal relations that may be partial, instantaneous, and unrelated to the comprehensive and long-term situation. If we use abstract thinking, we may approach the truth. However, abstraction may vary among different people and may not be representative or may be error-prone because of our limited perspectives and abilities. If we use concrete, holistic thinking and consider a patient as an indispensible and constant entity with local changes, we can obtain a more comprehensive understanding of the patient for more appropriate treatment. We have gone to great lengths to study and advocate HIM given that qualification is considerably more important than quantification in medicine.
Although the essence of life continues to shorten, humans expect longer years of existence. This contradiction validates the importance of medicine and its development. Despite our accumulated knowledge from medical studies and experience from medical practice, the needs in health care, therapy, and rehabilitation cannot be totally met. Therefore, there is an increasing demand for continuous medical exploration. HIM neither denies the nature and contributions of empirical and scientific medicine, nor does it separate itself from tradition, experience, and science. On the contrary, HIM utilizes these fields as foundations, and develops and refines them to meet new historical demands. HIM is not about embracing the new and ignoring the old, but bringing forth the new through the old. It is also not about turning back but moving forward. Because HIM is looking ahead and moving forward, it is bound to expand a new field in a new era of medical research [
29].
Higher Education Press and Springer-Verlag Berlin Heidelberg
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