"Integration is a hallmark of our era's development and a magic key to solve epochal problems." "Medicine originated from humanity's initial expression of suffering and the primary desire to alleviate that suffering." From this origin, human medicine has continually advanced through repeated challenges, displaying two major characteristics in its development:

1. "Dimensionality reduction and differentiation are the driving forces of medical development." Since the introduction of natural science paradigms and methods into medicine, the process has evolved from complexity to simplicity, and from difficulty to ease. The method of continuous dimensionality reduction and differentiation has indeed been instrumental and praiseworthy in the development of modern medicine. However, as medicine extends and deepens in scope, and as subjective and objective cognition collide and diverge, the analysis and description of human life and disease have evolved. Especially with humanity's yearning for health and longevity, medicine has been singularly focused on microscopic exploration. The artificial classification, specialization, and division has increasingly detached from reality, leading to over-specialization, over-division of disciplines and the fragmentation of medical knowledge, and even misunderstandings like "blind men feeling an elephant" or "treating the head for a headache and the foot for a footache." These epistemological and methodological biases indeed grow in impact and cannot be underestimated.

2. "Dimensionality enhancement and integration are the directions of medical development." The proposal and practice of Holistic Integrative Medicine, abbreviated as HIM, represent a conscious reflection and correction of medical development and its theories, a high-level return and rectification in medical progression, and a transformation of traditional concepts and adjustment of existing methodologies [1].

In the narrow sense, HIM views the human body as a holistic entity, organically integrating the most advanced knowledge and theories from various medical fields with the most effective clinical experiences and techniques. This involves converting the data and evidence obtained from medical research back into their original facts, transforming knowledge and consensus gained from clinical practice into experience, and consolidating techniques and arts discerned from clinical explorations into medical approaches. This process involves cyclic verification at the levels of facts, experience, and medical practice, followed by revisions and adjustments based on social, environmental, and psychological conditions. It emphasizes a human-centered approach and the unity of nature and humanity, thereby forming a new medical knowledge system more aligned with health care and disease prevention [2].

In the broad sense, HIM is not a specialty, a division, or a technique. It is a medical epistemology, aimed at studying the essential characteristics and formation methods of medical knowledge, guiding medical personnel in correctly researching and treating diseases, and using existing medical knowledge to create a higher-level medical knowledge system [3].

        I.  HIM advocates that the whole is greater than the sum of its parts. The whole is not a mere assemblage of parts but an organic integration. Specialists and sub-specialists should consciously observe, analyze, judge, and handle their actions within the whole. They should avoid unintentionally or intentionally emphasizing and magnifying the parts, which could distort the analysis of the whole, leading to improper handling and abnormal effects.

      II.  HIM promotes actions that are closer to the true nature of life and disease. It seeks to clarify the negative impacts of "artificial choice, intervention, interference" on medicine and to reduce and avoid such subjective and harmful interferences in clinical and research settings. Medicine has no fixed parameters, only infinite variables, with parameters specific to individuals and variables differing by person, place, and time. Simplified mathematical inference, statistical constraints, and logical proof have certain limitations and one-sidedness in medicine. Only multifactorial integrative analysis considering dynamic changes is beneficial to medical research and clinical practice. Therefore, scientific research results should be verified in real medical scenarios, confirming their efficacy and benefit to human bodies before applying them to healthcare.

    III.  HIM emphasizes that human functions far exceed structural manifestations and highlights the emergent properties. It stresses transforming the biomedical model into a biopsychosocial model rather than fragmenting it, underscoring the significant impact of social and psychological factors on biological health.

    IV.  HIM advocates for "following nature," emphasizing not only actions against bacteria, viruses, and cancer cells but also fully mobilizing the body's natural forces such as vitality, self-healing, and immunity to prevent and treat diseases or maintain and restore health. It values the synergy and integrated forces at multiple levels, thus acting in accordance with circumstances and trends.

      V.   HIM insists on starting from reality, emphasizing the guiding role of ivory tower knowledge from research and education, while also focusing on grassroots, rural, and practical applications. It advocates a reverse exploration path from discovering problems to researching and solving them, aiming to enhance clinical skills and academic level for holistic integrative medicine. This process corrects, nourishes, and enriches the knowledge base in the ivory tower.

    VI.  HIM promotes combining medicine with prevention, emphasizing prevention as the primary approach. "Top-level practitioners treat diseases before they occur." "Let the populace get sick less, hospitals see fewer patients, and health insurance pays less." Health education and popular science should be conducted from an HIM perspective rather than a specialist viewpoint, achieving more with less effort.

 VII.  HIM advocates for the integrated development of Chinese and Western medicine, emphasizing "Chinese learning as the foundation, Western learning as the application," and valuing both equally. It respects the disease management model derived from the largest sample size over five thousand years of continuous refinement by the Chinese people, seeking not only instrumental rationality but also value rationality. This is the practical strategy and cultural confidence for HIM to go global.

VIII.  HIM advocates continuously summarizing successful medical experiences through scientific research, while considering the differences between medicine and natural science. It emphasizes reverse and negative research, promoting bidirectional thinking to form a closed-loop research model. Considering the dynamic changes in medical phenomena is essential to find the truth about the human body as a complex and open system.

    IX.  HIM emphasizes the role of drugs and techniques in disease diagnosis and treatment, but even more so the overall effect and quality of life in health care. It reminds us that while pills and scalpels can often prevent premature death, they are not enough to enhance quality of life and achieve higher levels of health and longevity.

      X.  HIM posits that medicine is not purely a science. It defines HIM as "the truest science, the kindest art, and the most beautiful humanity," embodying an organic integration of "truth, goodness, and beauty." It emphasizes that medical humanities are the "steering wheel" and "brake pads" of its development, highlighting the need for coordinated guidance by HIM in medicine's differentiation-driven progress. It addresses "who and what medicine truly cares about" and stresses the need for ethical constraints in medical research and practice to achieve balanced and controlled development.

Notably, as HIM progresses, more propositions will continue to emerge and be emphasized, as integration remains an eternal theme in medicine.

To achieve the grand policy of Healthy China, it has been proposed that "by 2035, China should form an integrated medical and health service system that aligns with the basic realization of socialist modernization, with a complete system, clear division of labor, complementary functions, continuous coordination, efficient operation, and resilience." The enhancement of HIM concepts and practical empowerment aligns with this vision. For the health and longevity of the populace, to confront the true nature of life and disease, to maximize the effectiveness of medicine, and to honor the sanctity and glory of medicine, HIM is destined to become the new era of medical development following the eras of empirical and biomedical medicine [4,5].

Acknowledgement

The declaration was released in Chengdu on June 22, 2024, jointly signed and advocated by over 100 academicians from Chinese Academy of Sciences and Chinese Academy of Engineering, and more than 100 presidents from medical universities across China.

 References