However, the period of the end of the 19th century, 20th and 21st century is historically associated with the destruction of the Chinese medical tradition. At the end of the 19th century, China was astonished by the military and technical advantage of the West shown during the Opium Wars. This brought the Chinese intelligence into depression and shattered the idea of the inviolability of China and the strength of its culture. At that time, many Western medical advances were significantly more effective than those of China, especially in the elimination of infectious diseases the epidemics of which were still raging in China, while Europe almost forgot the plague, cholera and other pestilences. Then the Xinhai Revolution of 1911 followed as the overthrow of the imperial power that had been considered sacred for thousands of years and the demolition of the roots of tradition. Further, there was the civil war, the war with Japan, and the Cultural Revolution (Elman 34-51) [1] .
At the same time, medicine, like any science, is, among other things, a certain school of continuity of knowledge; and this continuity is carried out not just textually, but directly from teacher to pupils (professor to students, post graduates, etc.) (Hsu 24) [2] . However, since the mid 19th century, under the influence of Western colonial powers the traditional Chinese medicine entered the decline. The ruling power of the country began to give preference to Western medicine, while traditional Chinese medicine was discriminated against as primitive and backward. Things came to the literal suppression of Chinese medicine during the Kuomintang government (1912 - 1949). Only after Mao Zedong came to power, the revival of traditional medicine began, which brought it an international recognition again. Currently, the PRC recognizes that the future of Chinese medicine lies in a combination of traditional Chinese and modern Western techniques (Gu 203-34) [3] .
Further, we will consider the development of Chinese medicine, approaches and technologies in the 20th century and analyze the main trends.
Development Dynamics
Political instability in the early 20th century not only gave rise to a rapid surge of mysticism, but also stimulated interest in Oriental medicine. Unfortunately, the lack of genuine scientific evidence has led to confusion of notions: acupuncture was often considered to be associated with magic and spiritualism (presently, mass European consciousness is often inclined to perceive acupuncture as part of oriental martial arts). In the 1930's, the Nazi leadership of Germany, and personally A. Hitler, showed a great interest in mysticism and oriental medicine along with it. It is known that in 1938 a special scientific expedition was sent to China to explore the abilities of acupuncture as a means of military medicine. It is ironic that in Japan, which was an ally and political partner of Germany, Zhen Jiu was by this time almost forgotten, and the Japanese government showed greater interest in "secrets" of European military medicine (Unschuld "Medicine in China: A History of Ideas" 59-61) [4] .
In the late 1940's and 50's the new trends in the development of acupuncture appeared (Elman 94-101) [5] :
- the new governments of China, Korea, Vietnam, Japan and other countries of the region made efforts to revive traditional medicine within public health systems, thus attempting to compensate for the acute shortage of specialists in Western medicine;
- in America and Europe, new medical directions were developing, which combined the achievements of Oriental and Western medicine, successfully applying technological advances.
After the formation of the PRC in 1949, considering disease prevention, health protection and further development of traditional medicine as an important part of the strategy, the Chinese government paid great attention to the active establishment of medical and health facilities and medical training. Hospitals of different levels and medical organizations were located all over the country to develop an integrated treatment and prevention network in urban and rural areas. Healthcare in China became the most important state activity (Taylor 23-27) [6] .
Nowadays, China has a great number of medical specialists, a well-developed integrated system of education of medical sciences, which has produced for the country numerous outstanding experts in medicine and pharmacology. By the end of 1999, there were 310 thousand healthcare organizations (including ambulance), 3.14 million hospital beds (in hospitals and sanitary and epidemiological services - 2,91 million), 4.42 million medical staff working in this field (1.41 million doctors in hospitals and sanitary & epidemiological services, 1.07 million nurses), which, respectively, 85.6, 36.9 and 8.8 times more compared
with what was available in 1949 (Gu 203-34) [7] .
The level of medical science has been rapidly increasing in subsequent years; the control over medicines and sanitary inspection has been continuously enforced. A system of health insurance for workers and employees in towns and cities has been created basing on community planning and contributions from individuals with the scope of this system gradually expanding. Traditional Chinese medicine and pharmacology, as well as the combination of methods of Chinese and Western Medicine are developing together nowadays. The incidence of many infectious diseases has been decreased significantly, epidemics have been localized, medical and health work in rural areas have been enhanced, thus improving the health of the population. China has finally occupied the leading positions among the developing countries by the average life expectancy, reduction of infant mortality and the number of birthing mothers; by now, some indicators have reached the level of developed Western countries.
Improvement of the three-stage treatment and prevention network in rural areas
About 75 percent of China's population lives in rural areas, so the medicine and health care in these areas are constantly in the spotlight of the government (Xu 123-31) [8] . After 1978, since the policy of reforms and openness, the country's medical authorities have set themselves to the further development of the rural sanitary operation and provision of the countrymen with healthcare, considering it one of the key moments of the construction of new socialist countryside with Chinese features. Along with this, based on comprehensive development of rural medicine, general hygienic measures have become primary.
Currently, the three-stage (county, township and village) treatment and prevention system is mainly used in rural areas. In 1998, China had 2,037 county-level hospitals, 50.6 thousand township sanitary and epidemiological services; almost 90 percent from 730 thousand villages across the country established 728.8 hospitals or clinics. Around 1.328 million doctors and health workers work in rural areas with rural doctors numbering up to 74.59 percent (Leung and Furth 45-48) [9] . China has laid a good foundation for achieving the objective set by the World Health Organization - "Providing health care for all by 2000."
Transformation of the healthcare system
In accordance with a system of public healthcare service and employment insurance, created in the 1950's, in China, the treatment of workers and employees in case of illness or injury is carried out at the cost of the state (Taylor 78-79) [10] . This system has played an active role in protecting the health of workers and employees, promoting economic development and social stability. However, with the development of economy and deepening reform of the economic system of the country, its disadvantages started to show. Since medical care is usually paid by the state and enterprises, the costs for these purposes are growing too fast and have become a burden on the state budget. On the other hand, the waste of sanitary and hygiene resources are inevitable. Medical care in rural areas, except for a few wealthy regions where it is available free of charge, is still paid. The system of general medical services of the country is not yet perfect, its scope is small, and therefore, the reform of the system of public health services is necessary.
This reform provides the setting of the expenses reimbursement mechanism for medical institutions in cities and towns. This means that the health insurance system should take into account local financial and social conditions; treatment costs should be covered by the state and enterprises, as well as the patients themselves. In rural areas, cooperative medical care system should be fully developed and improved under the leadership of local governments, which operate at the expense of society with financial assistance from the government and on the basis of voluntary participation. Establishment of insurance funds is planned to be implemented mainly through contributions from individuals and support from corporations and local authorities to provide basic medical care to countrymen, meet the challenges of disease prevention and escape poverty due to illness. Expanding the coverage of health insurance is not only conducive to full and timely care by medical institutions, but also meets the requirements of sustainable development of medical facilities (Chen 15-21) [11] .
Disease Prevention Strategies
Making prevention the corner-stone is an important experience of medical work in China. Active prevention of infectious diseases, epidemics, parasitic diseases, etc. is the main focus of health institutions at all levels. China completely eradicated smallpox back in the early 1960's, which is more than 10 years earlier than in many countries of the world (Taylor 89) [12] .
During 50 years after the founding of the PRC, the country established medical facilities with the focus on sanitary & epidemiological stations intended for sanitary surveillance and disease prevention. A general sanitary supervision and epidemics control network of China was formed. In 1998, there were 4,018 such establishments, including 1,696 county sanitary & epidemiological stations, 1,889 specialized departments or prevention and treatment stations (Leung and Furth 56-59) [13] .
In order to completely eliminate or localize infectious diseases and epidemics, the Chinese Government issued the "Law on Prevention and Treatment of Infectious Diseases", "National Plan of Action on Eradication of Poliomyelitis by year 1995", "Program on Eliminating Iodine-Deficiency Diseases by 2000" and other documents, also actively developing immunization. The immunological vaccination of children was successfully carried out, which markedly reduced the incidence of measles, diphtheria, polio, pertussis, epidemic encephalitis B and other diseases (Gu 203-34) [14] .
Currently the disease prevention is being effectively conducted along with the patriotic movement for sanitation and hygiene. General health of urban and rural population has improved significantly compared to the period before 1949. Average life expectancy across the country has grown from 35 to 70 years. Mortality causes are now mainly malignant tumors, diseases of the head blood vessels and cardiovascular diseases. In this respect, the situation in China is similar to the situation in developed countries. Research and medical institutions are unfolding active prevention of cardiovascular and cerebrovascular diseases, oncosis and other chronic non-communicable diseases, monitoring outbreaks of infectious diseases both in the country and abroad. In 50 years, the PRC has made considerable progress in preventing and treating diseases. The division on the localization of disease at the Ministry of Health of China in 1996 was awarded by the World Health Organization for the outstanding achievements in their work (Chen 34-39) [15] .
Health Protection for Women and Children
Since the founding of the PRC, the Chinese government has paid much attention to the health of women and children. NPC and CPPCC respectively established the institution on legal rights and interests of women and children and the office on supervision over the execution of laws. The State Council and local governments set up committees to work with women and children. By the end of 1998, there were 2,724 medical and health facilities for women and children throughout the country, including 1,507 county stations for protecting mother and child health, and 73 thousand staff. An integral network of institutions was set to protect the health of women and children covering the whole country (Leung and Furth 102-111) [16] .
In order to ensure real protection of women's health such documents were issued as the "Law of the PRC on the Protection of Rights and Interests of Women," "Mother and Child Health Law," "Regulation on Labor Protection for Women Workers," Interim Provisions on the Protection of Health for Women Workers and other legal acts. China is taking active measures on applying safe obstetric aid methods and means to protect the health of women in the childbearing period. Urban and rural hospitals have introduced compulsory medical examination of pregnant women, the registration of early pregnancy, care for extremely risky pregnancies, deliveries in the hospital, post-natal care and other measures to ensure the health of mother and child. These measures have given positive results in the protection of mother and child health in China, for example, maternal mortality rate decreased from 1,500 cases per 100 thousand in 1949 to 61.9 cases in 1995 (Scheid "Remodeling the Arsenal of Chinese Medicine: Shared Pasts, Alternative Futures" 136-59) [17] .
Since 1978, the Chinese government pays great attention to protecting health and monitoring the development of children. Special China children welfare programs were developed, as well as the "Law on the Protection of Minors" and the program to promote breast milk infant feeding. At the same time, the movement for the care of newborns was launched, 5,890 hospitals for newborn care were created across the country, due to which infant mortality declined from 200 cases per thousand newborns before 1949 to 31 per thousand. In 1978, the national planned immunization was implemented (Gu 203-34) [18] . Thus, the level of physical development of children is steadily increasing and their nutritional status is improving.
Traditional Chinese Medicine and Pharmacology
Chinese medicine and pharmacology is an important part of the culture of the Chinese nation. For several thousand years, they have made an outstanding contribution to the prosperity and power of China. Chinese traditional medicine differing with its remarkable curative effect, national identity, specific diagnostic and treatment methods, systematic theoretical propositions and numerous historical documents, takes its special place in the medical world and has become a common wealth of the treasury of the world medical science. Chinese medicine has a many centuries history and still shows its great vitality in our times. Traditional Chinese medicine and modern medicine are mutually complementary, which is its specificity and advantage.
The main theoretical views of Chinese medicine are in the original knowledge of dense and hollow visceral organs, meridians and collaterals, "Chi" and blood, body fluids, causes of disease and pathogenesis. Chinese medicine treatment methods are "the four principle of patient's examination" and the study of disease: visual (studying face color), auditory (listening to patient's voice), oral (questioning patient's state) and touching (feeling patient's pulse). The study of the disease means the process of learning the causes of the disease through analysis, induction, research and reflections on the basis of symptoms of the disease and physical symptoms observed during the four principle of patient's examination. Apart from the basic method of treatment based on the use of medications, Chinese medicine also uses acupuncture, massage, breathing exercises "Chi Kung" and some other original treatment techniques (Unschuld "Medicine in China: A History of Pharmaceutics" 36-58) [19] .
Since its founding, the PRC has considered Chinese medicine extremely important to support its development. In 1986, the State Administration of Traditional Chinese Medicine was established. Two years later it was expanded to the State Administration for Traditional Chinese Medicine and Pharmacology which develops the strategy, principles, policies and regulations in this area. It provides an orderly combination of Chinese medicine and pharmacology and manages their integration (Elman 234-35) [20] .
By the end of the 20th century, education in the field of traditional medicine has been rapidly developing, creating new higher and secondary educational institutions with teaching of Chinese medicine and pharmacology, correspondence institutions, evening institutes, schools, as well as external studies system (Wu 211) [21] . All this helped the country to produce a large number of experts in Chinese medicine. The Chinese medicines manufacturing developed an integrated system with diverse range of products and advanced technologies. In China, doctors of traditional medicine learn from each other, trying to find a way of combining methods of Chinese and Western medicine, which has become an innovation for China. Currently, there is a situation where the Chinese, Western and Chinese-Western medicine coexist, taking positive trends from each other and develop jointly (Scheid "Chinese Medicine in Contemporary China: Plurality and Synthesis" 51-68) [22] .
The system of theoretical views of the Chinese medicine has deep content. The researchers of the Chinese-Western medicine, using advanced science and technology and modern methods, conducted a long-term study on the basic theoretical knowledge of Chinese medicine and its treatment methods. Therefore, they achieved success in academic commenting of the dense and hollow visceral organs, blood stasis and the essence of acupuncture treatment. China is the world leader in 5 areas of medicine, including the replantation of severed limbs, burns treatment, fracture treatment, treatment of acute diseases of abdominal cavity and acupuncture anesthesia. Advances in the last 3 areas were achieved by combining methods of traditional Chinese medicine and Western medicine (Scheid "Chinese Medicine in Contemporary China: Plurality and Synthesis" 51-68) 22.
Lately, encouraging progress has been obtained in the treatment of cardiovascular and cerebrovascular diseases, immunological diseases, oncosis and fractures using the methods of Chinese medicine. Opening and systematization of recipes of traditional therapy, processing and preparation of Chinese medicines and changing the form of the finished drugs were a new development, which improved preventing and treating diseases with the methods of Chinese medicine, and expanded its services. Chinese medicine in the treatment of acute diseases of the abdominal cavity discovered new methods of non-operational treatment (Capie 98-105) [23] .
Traditional means of Chinese medicine - acupuncture treatment, anesthesia and pain killing are now widespread in 120 countries and regions around the world. In 1987, the World Federation of Acupuncture was founded in Beijing, which involves more than 50 thousand representatives from 100 countries and regions. It is the first international scientific organization with headquarters located in China, and its administration is China. In 1989, Beijing hosted an international conference on Chi Kung therapy which was attended by representatives from 29 countries and regions. In 1991, China held the International Conference on Traditional Medicine and Pharmacology, at which dozens of countries have jointly developed and adopted the "Beijing Declaration". Presently, China has already established relationships in healthcare, research and academic exchange with more than 100 countries and regions in the world (Chen 50-52) [24] .
In recent years, along with the distribution of homeopathic treatment methods and non-drug treatment Chinese medicine has attracted attention around the world. The framework of international cooperation in the field of medicine is expanding. Japan, the U.S.A. and Germany have established cooperative relations with China. World Health Organization has created 7 cooperative centers of traditional medicine and pharmacology in China. Among all the foreign students and trainees studying natural sciences in China, the largest part is experts in Chinese medicine. Joint teaching of Chinese Medicine by Beijing Institute of Traditional Chinese Medicine and State University of England has become a precedent of opening a specialty of Chinese medicine in other universities in England and Europe. In Japan and Korea there are schools of Chinese medicine; in France, the USA, Italy, Australia and other countries - institutes of Chinese medicine and acupuncture institutes; in Germany, the University of Munich includes institute for the study of theoretical knowledge of Chinese medicine (Jennings 457-73) [25] .
According to the State Administration for Traditional Chinese Medicine and Pharmacy, during the implementation of the 11th Five-Year Plan for Social and Economic Development (2006-2010) the government annually increased allocations for the development of traditional Chinese medicine. If in 2005, such appropriations made 4.1 billion yuan (1 U.S. dollar equals to about 6.5 yuan), in 2009 they were increased to 11 billion yuan. During the period from 2006 to the present day, the Chinese Government has provided targeted funding for projects on construction of 16 bases of clinical research in the field of traditional Chinese medicine, 313 leading hospitals of traditional medicine at urban and provincial level, 753 hospitals of traditional medicine at the county level (Chen 53-58) [26] .
In addition, during this period, the government made great efforts to enhance the ability of hospitals to develop and manufacture drugs of Chinese medicine, to distribute the experience of well-known and prominent doctors of traditional Chinese medicine, to expand the application of traditional Chinese medicine in the treatment of common diseases in the villages, as well as to spread the knowledge of traditional Chinese medicine and pharmacy among the population.
The latest influence of Western medicine and possible perspectives of Chinese technologies in the 21st century
Acupuncture and herbal medicine are typical treatments in Chinese medicine. However, it is possible that in the near future it will be difficult to have an acupuncture procedure even in China, because the number of healers in the country is rapidly declining during the last decade. It should be noted that before the wide spreading of European medicine with its chemical drugs in China in the second half of the 20th century, the Chinese used to go only to folk healers who used natural ingredients and knowledge of ancient medical treatises (Capie 98-105) [27] .
Despite the fact that the Chinese are accustomed to their traditional medicine, it did not pass the test for economic benefit. This activity does not bring a decent income to professionals and as a result, the study of traditional medicine is becoming less popular.
According to Professor of Traditional Chinese Medicine of Beijing Medical Institute, Liang Rong, educational resources aimed at training specialists in traditional treatments are being wasted. Often, having obtained the degree in traditional Chinese medicine, young people employ in companies selling medicines and medical equipment, where they can get a decent salary (Wu 211-223) [28] .
Crucial difference between modern Western and ancient Chinese medicine is rooted in the difference of their initial positions related to the epistemology. The Chinese system of healing begins with the determination of broad relationships, on the basis of which many observations and conclusions by analogy are taken into account, and practical medical measures are developed. A Western doctor begins with measurement and analysis of the smallest detail, knowing which he expects to understand the phenomenon as a whole. He uses the opposite way (Jennings 457-73) [29] .
Since we are dealing with the phenomena related to the theory of knowledge, it is necessary, above all, to explain the notion of "science": in contrast to the disordered knowledge (empiricism), science considers not just a phenomenon, but also the causes of things. It goes analytically from whole to part, and synthetically from part to whole; by induction from experience and observations to the concepts, findings and conclusions from the private, particular to the general, and by deduction from general to particular, constantly testing one through another. Scientific progress consists in an infinite systematic insight into the reality, both by the breadth and depth, into elements of being and events, and the understanding of their interrelations, understanding of the great interrelation of the reality which is called environment. This concept of science formulated in the West is currently accepted worldwide, including China, which makes great efforts to bring this idea of science to people's consciousness, though in a form of dialectical materialism. China is currently importing ever increasing amounts of scientific ideas, technological advances, equipment and medical products from the West.
Conclusion
Taking into account the fact that during the 20th century in China the entire traditional order of knowledge was broken, as well as the way of its transfer, training centers were destroyed, knowledge bearers were physically liquidated (during the Cultural Revolution, even the knowledge of a foreign language or education could mean a death sentence), it is impossible to speak of the existence on classical Chinese medicine today. But in the mid-1950's the country's leadership gave the command to literally create traditional Chinese medicine anew, cleaning it from "feudal remnants". And the Procrustean bed of consciousness of uneducated "cleaners", socially active amateurs and party functionaries actively took work over. What they did not manage to implement was completed by the Cultural Revolution of the 1960's. However, the problems for the Chinese medicine did not end after that. When China managed to recover from the disturbances of the 20th century, it turned out that once again China was far behind the West in science and technology development, which had to be overcome quickly. To bridge the gap, China started borrowing cutting-edge ideas. And that is why today China shows an unprecedented economic boom.
Borrowing reached the medicine sphere, which put it in a strange situation: on the one hand, the traditional medicine with its "feudal remnants" was abandoned, but it was used as a basis, on the other hand, purely Western medicine was not fully accepted, because of the reliance on the contracted version of the traditional Chinese medicine. There occurred a considerable controversy not reflected in the context of culture. But since the promotion of Chinese medicine works even at the state level, the foreigners come to China for a cure, while the wealthy Chinese themselves seek treatment in the West, and the ordinary citizens in hospitals of Western medicine in China. Naturally, due to such absurdities, medical education in China obtained very strange nature. Firstly, there are two big specialties, Chinese and Western medicine, but both ones study the opposite medicine in some crumpled form. Secondly, education itself is based on an endless cramming and exams are held only in writing, mainly in the form of tests. And due to the peculiarities of the political system the development of science and free scientific debate as a factor of scientific development is complicated; at the same time, traditional reverence for authority and literalism is thriving.
