Do some harm

Traditional Chinese medicine is an odd, dangerous mix of sense and nonsense. Can it survive in modern China?

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Facial acupuncture is administered to a patient in Beijing. Photo by Justin Jin/Panos

Facial acupuncture is administered to a patient in Beijing. Photo by Justin Jin/Panos

James Palmer is a British writer and editor who works closely with Chinese journalists. His latest book is The Death of Mao (2012). He lives in Beijing.

A few minutes after getting her traditional Chinese medicine injection in a hospital in Chongqing, southwest China, 25 year-old Zhang Mingjuan began hyperventilating. She’d had only a slight fever, but wanted to try the appealing combination of traditional medicine with the more rapid vector of a jab. Now she felt like she was dying, and she passed out.

In the hospital emergency room, where she awoke, she was told that quick treatment saved her life from the allergic reaction to the shot — a mixture of herbs and unlabelled antibiotics. Later, doctors told her that she would have been better off sticking to hot water and aspirin.

The combination of traditional medicine and hospital setting, of pseudoscience and life-saving treatment, might seem strange. But in modern China, traditional Chinese medicine (TCM) is not the realm of private enthusiasts, spiritual advisers or folk healers. It’s been institutionalised, incorporated into the state medical system, given full backing in universities, and is administered by the state. In 2012, TCM institutes and firms received an extra $1 billion in government money, outside the regular budget. TCM as a whole is a $60 billion dollar industry in mainland China and Hong Kong.

In pharmacies, TCM prescriptions are jumbled on the shelves alongside conventional drugs. Staff often see little difference between prescribing one or the other and don’t tell patients whether they’re receiving TCM or conventional treatment. Approximately 12 per cent of national health care services are provided by TCM facilities, although that figure includes conventional medicine done at TCM institutions.

Every major Chinese city has a TCM hospital and university. While folk medicine shops have the cluttered appearance of an alchemists’ den, institutionalised TCM presents itself as clean, organised and scientific, with staff, even administrators, bustling around in white lab coats. The majority of TCM drugs are sold in foil packets and shiny capsules.

Beautiful and intricate as they are, these theories don’t correspond with the messy realities of bodies cobbled together by the long randomness of evolution

Yet the theoretical underpinnings of these treatments is essentially pre-modern. Traditional Chinese medical theories see the body as composed of the interaction of different elements, processes, and fluids: the elements of fire, water, earth, metal, and wood; the interplay of yin, yang, and ‘qi’ (the life force). Each of these comes with its own correspondences: fire matches the south, red, heat, the heart, and the tongue. The body is a microcosm that mirrors the macrocosm of the universe, a grand design reflected in each person’s form

Illness arises when excesses disrupt the balance between the elements, manifesting in wind, fire, cold, dampness, dryness, and heat. Nature provides symbolic clues to treatments that can fix these imbalances: a herb that looks like the heart, the hand or the penis can be used to treat ailments in those body parts. Animals, too, carry cures within them: the roaring power of a tiger can be extracted from its bones; the strength of an ox from its gall stones. Many of these ideas are recognisable from pre-modern Western thought: the four humours of Galenic medicine or the principles of a monastic herbarium would not be foreign to Chinese healers. Nor would Leonardo da Vinci’s Vitruvian Man, limbs outstretched, and encapsulating in the human body the proportions of the universe, look out of place in a Chinese medical classic. Humans look for patterns, and for projections of themselves into the universe.

Beautiful and intricate as they are, these theories don’t correspond with the messy realities of bodies cobbled together by the long randomness of evolution. The human body isn’t a mirror of cosmic realities any more than it is a perfectly designed machine, but a clumsy improvisation, full of incompetent or redundant parts. Traditional Chinese medical theory suffers from the same problems that Renaissance thinkers identified in astrology and other pre-modern sciences: ‘This idea is very pretty, rather than natural and true,’ as the 15th-century philosopher Giovanni Pico della Mirandola wrote. Like the bodily humours, the equally immeasurable yin, yang and qi, as well as the body’s ‘meridians’, belong to the realm of spiritual and psychological practice, not scientific inquiry. That doesn’t render them less real, but it’s a shaky basis for a biological theory.

Still, even if traditional theories of medicine do not describe bodily reality, they are important in other ways. The idea that an illness might be a symptom of a lack of balance in our lives resonates powerfully. The idea of spirit in all its guises still infuses Western culture, but it can’t be measured any more than qi can. Nor any more easily dismissed: Robert Burton’s The Anatomy of Melancholy (1721) is suffused with humours, astrology and demons, but it’s still a book of wisdom and insight — both into our own minds and those of Burton’s day.

The spiritual and psychological insights of past Chinese writers and thinkers on medicine are still meaningful, and they provide us with keys to other great texts of the Chinese past. Just as a student of Shakespeare needs an understanding of Galenic medicine — ‘I’ll curb her mad and headstrong humour,’ says the choleric Petruchio of his equally volatile new wife in The Taming of the Shrew — so a student of a Chinese classic such as The Dream of the Red Chamber (1791) needs an understanding of TCM. But though these insights might inform good medical practice, or the ways in which we treat our own bodies, they’re not a basis for science, or for reproducible treatment.

For all that, TCM ideas suffuse Chinese popular thinking about health and there’s a fierce defensiveness associated with them. Opposition to TCM makes a person stand out, even when the critic is inside Chinese culture. In the ‘anti-TCM’ group on the social media site Douban, with its symbol of a crossed-out yin-yang sign, posters share experiences of bitter family arguments. Wu Meng, 25, is firmly opposed to the practice. ‘I really like [the popular scientific crusader] Fang Zhouzi’s books,’ she told me, ‘And anyone who thinks can see that TCM’s just rubbish, and not scientific at all. But even educated people believe in it. My boyfriend is in finance, and super-smart, but he has a whole drawer full of this crap. My mother is a [conventional] doctor, but my family thinks I’m just against TCM out of contrariness, and that I’ll change my mind.’

At the public level, opposition comes with greater costs. Zhang Gongyao, 56, started studying TCM in 1974, as a ‘peasant straight out of senior school. Because of the Cultural Revolution, I had lost my hope for a reliable future. So I studied and practised TCM in the hope of a reliable future.’ Over the years he lost faith in TCM, especially in the institutionalised system. He became a professor of philosophy, specialising in medical history, at the Central South University in Hunan, and in 2006 launched an online petition calling for the removal of TCM from the government-run medical system. Although it was signed by more than 10,000 people, it was dismissed by the State Administration of Traditional Chinese Medicine (SATCM) as a ‘farce’, with Zhang accused of being ‘ignorant’.

At a time when virtually every other traditional practice was being consigned to the bonfires, TCM practitioners had some ideological and governmental shelter

‘Since then,’ he said, ‘I have borne a lot of pressure from the government, from the university, and from the existing TCM institutions. I can’t publish my papers freely; I’m blocked from the normal promotions and salary raises; and I can’t even always lecture to my students.’ Zhang’s fate is not unusual for anyone who challenges a government institution in China, whatever the area. But why has TCM retained such power and influence — both popular and official — when traditional medicine in China’s neighbours, such as Korea and Japan, has been pushed to the margins?

The institutionalisation of TCM was not inevitable. It arose out of China’s damaged encounters with the West, out of the ideological struggles of the 1930s, and the political needs of the early People’s Republic. And like most traditions, from kilts to Christmas trees, it’s a lot younger than people think.

Until the 19th century, there was no such thing as ‘Chinese’ medicine in China, just medicine. This encompassed an eclectic and often-changing range of treatments and practices that generally harked back to ancient medical texts, such as the Huangdi Neijing, the ‘Inner Classic of the Yellow Emperor’, but it was also willing to experiment and innovate. Like European medicine, it could be empirical and curious: the Neijing, for example, stresses the importance of taking case histories. Given that ideas were transmitted along the Silk Road from Europe, India and the Middle East, and vice versa, the resemblance between TCM and medieval European medicine is probably not all parallel development.

When Chinese doctors first encountered European medical ideas, they did so as curious equals, willing to concede that the newcomers had some things right, but also recognising that other treatments and beliefs lagged behind Chinese practice. Before the mid-19th century, a patient was probably better off going to a Chinese doctor than a Western one; the odds of either being helpful were slim, but at least the Chinese doctor, thanks to a disdain for internal intervention, wouldn’t slice you open with unsterilised instruments.

But as Western medical science was revolutionised by germ theory, by anaesthesia, and by public sanitation, the gulf between it and medicine in China widened, coinciding with China’s growing unease about its place in the world. Humiliated in the Opium Wars (1839-1842, and 1856-1860), threatened from without and collapsing from within, Chinese intellectuals struggled to see the path forward. For some, it meant harking back to lost greatness; for others, it meant abandoning the old for newly imported, superior methods. ‘Substantiate in detail the theory that Western methods all originate from China,’ asked one exam question for applicants to the civil service after the exams were revised in 1900, while ‘Explain why Western science studies are progressively refined and precise’ asked another.

In 1890, the Qing scholar Yu Yue published a full broadside against tradition, On Abolishing Chinese Medicine, after losing his wife and children to illness. In 1896 Lu Xun, China’s greatest modern writer, watched his father die as the family’s wealth was squandered on increasingly expensive and rare traditional treatments; he later trained as a Western doctor in Japan in reaction against what he called the ‘unwitting or deliberate charlatans’ of traditional medicine. In one of his bleakest stories, ‘Medicine’ (1919), a family desperately seeks a magical cure in the blood of an executed rebel.

The Nationalist government of the 1920s took a far greater interest in public health, seen as a vital part of China’s revival. Strong individual bodies meant a strong national body, one no longer seen as ‘the sick man of Asia’. With this came the need to organise and regulate doctors. But traditional and Western doctors had formed separate medical associations, each with a keen sense of their own importance. When, in 1929, the ministry of health proposed to abolish traditional medicine entirely, TCM doctors promptly called a nationwide strike, closing pharmacies and clinics across the country. As a result, two separate and parallel government institutions were created to deal with doctors — one ‘Chinese’ and one ‘Western’. Despite the government push to abolish TCM in 1929, in 1935 the Nationalist Party congress passed a resolution demanding ‘Equal treatment for Western and Chinese medicine.’

TCM’s claims of being ‘natural’ are highly appealing in country where everything from dumplings to baby milk can be toxic

The new Communist government of 1949 retained this legal structure, even though Chairman Mao had no time for Chinese medicine, dismissing its practitioners as ‘circus entertainers, snake-oil salesmen or street hawkers’. Yet in a country devastated by war and badly short on doctors of any kind, the vast numbers of traditional healers, and the institutions and regulations already in place to manage them, were a valuable resource. It was the Communist government that coined the term TCM, formally founding the State Administration of Traditional Chinese Medicine in 1954, and establishing many new TCM universities and institutions in the next few years, where TCM was formally stripped of its most obvious ‘superstitious’ elements, such as astrology and phrenology. The relentless drumbeat was on ‘scientification’ — the belief that the huge range of traditional practices could be systematised into an alternative national theory to ‘Western medicine’, or even integrated into broader medical theory.

Institutionalisation allowed TCM to survive the Cultural Revolution, and the earlier purges of traditional culture. At a time when virtually every other traditional practice — from religion to music to literature — was being consigned to the bonfires, TCM practitioners had some ideological and governmental shelter. Itinerant or independent practitioners outside of the umbrella of the SATCM were still humiliated and imprisoned, as were famous professors tainted by their pre-revolutionary practice. And TCM universities, like all other schools and universities, were closed for 10 years from 1966 to leave students free to take part in the ‘revolutionary struggle’. But by de-emphasising the ‘tradition’ part and emphasising its ‘Chinese-ness’, the advocates of TCM were able to tap into the enthusiasm for ‘people’s science’ and weather the storm.

Xixi, 23, a master’s student at the Beijing University of TCM, explained her own decision to study TCM, as she peeked at me from behind pink glasses over a pink face mask. ‘I grew up in Shandong, the birthplace of Confucianism. And so I’ve always been interested in Confucian ideas, and in traditional culture in general. I like the idea that “the one thing is connected to the hundred things”. My parents didn’t have the chance to explore traditional culture because of the Cultural Revolution, so they were very supportive of me doing so.’ For Xixi, as for many modern Chinese people, TCM represents a cultural continuity that powerfully resonates for those looking for the past.

That ability to survive is one of the major reasons for the popularity of TCM today. Virtually every other aspect of traditional Chinese culture has been shattered, sometimes beyond repair. An entire generation or more was lost, and that hollowness, the sense of something ripped out, still echoes through contemporary China.

Despite its massive economic growth, China is still a deeply uncertain country, especially when it comes to its place in the world. Belief in TCM is a comforting national myth. The West might have invented modern medicine, but China has something just as good! Such pride can blend into pure ethno-nationalism: I have twice been told that ‘The reason Westerners don’t believe in TCM is that it only works on Chinese bodies.’

TCM’s claims of being ‘natural’ are also highly appealing in country where everything from dumplings to baby milk to river water can be toxic. Talking to an acupuncture student, I suggested that science could identify the chemicals in herbal medicines. ‘Herbs don’t have chemicals!’ she protested sharply. ‘Chemicals are from factories!’

Workers prepare Chinese medicinal herbs. Photo by Natalie Behring/Panos Workers prepare Chinese medicinal herbs. Photo by Natalie Behring/Panos

There are more practical reasons for the popularity of TCM. China, which once had an equitable, if backward, health care system, was ranked 144th in the world for public access to health care, according to a report by the World Health Organisation in 2000. While TCM can be expensive, it’s considerably cheaper than conventional treatment, especially if surgery or scans are involved. For the poor, TCM or folk medicine can offer hope where conventional medicine closes its doors. A pot of herbal medicine boiled on the stove might not cure a leukaemia victim or substitute for unaffordable dialysis, but it provides the small comfort of doing something.

A fear of the modern has crept in, too: new mothers are told to avoid showering or watching TV

The Chinese public also distrusts conventional doctors, and with good cause. For starters, the level of education and training in the conventional health care system is astonishingly low. Only about 15 per cent of ‘doctors’ in Chinese hospitals have an MD, another 20 to 25 per cent have MAs, leaving the vast majority with only bachelor’s degrees in fields related to medicine or biology. Since doctors are severely underpaid, bribery is common, as is over-prescription of both expensive treatments and costly, sometimes fake, drugs. Public anger shows itself in many ways, from online applause for patients who’ve killed doctors in disputes over payment, to the angry crowd that stormed and wrecked a hospital in Guang’an, Sichuan, in 2006, after it was said that a three-year-old boy who had swallowed pesticide was refused treatment because his grandfather didn’t have cash in hand.

Unless you pay through the nose or pull strings, Chinese hospital treatment is a nightmare of bureaucracy, queues, and competition for the doctors’ attention. Some years back, I went to a midlevel Beijing hospital with food poisoning. Getting seen meant going to the main window, paying a fee, being given the name of a doctor on another floor, going to find him, paying a fee, talking to him for two minutes as other patients pushed between us clamouring to be seen, going to have my blood drawn by a nurse, paying another fee, going to the test centre to have it checked, paying a fee, going back to see the doctor carrying a vial of my own blood, pushing past other patients, and being prescribed some drugs and put on an IV drip for three hours in a hospital corridor on a hard plastic seat. For which I paid a fee.

In contrast, going to a TCM doctor is much like going to an alternative medicine practitioner in the West. You spend half an hour or longer talking with a nice, kind, probably quite wise person about your health, your lifestyle, the stresses you’re under, and they give you some sensible advice about diet, looking after yourself, and perhaps a dose of spiritual guidance on top.

Despite its institutional, cultural and popular backing, TCM is always under threat from the competitive edge of conventional medicine. There are outright charlatans who will prescribe TCM for cancer, but the TCM practitioners I talked to all said that for serious problems, with observable and immediate symptoms, they refer patients to conventional treatment. At the Beijing Hospital of TCM, the bulk of the treatments offered were conventional. TCM is strongest where conventional medicine is weak — chronic back pain, migraines, persistent fatigue: elusive conditions for which most doctors, short of an immediate cause, such as a tumour, will essentially throw up their hands and turn to general lifestyle and diet advice. But unlike TCM, evidence-based medicine advances both suddenly and surely.

For decades, erectile dysfunction made up a significant proportion of the TCM market, both in China and overseas. But with Viagra’s entry into the Chinese market in the early 2000s, the use of TCM has shrunk rapidly. A 2005 study in Hong Kong found that a large percentage of the TCM users surveyed had switched to Viagra, even though they stuck with TCM for other everyday ailments. Alongside this, the price of seal penises, once one of the most valued remedies, has dropped dramatically.

But some practices have surged in the past 30 years — and while many of them might have been sensible in the context of an agricultural, pre-modern society, they are actively harmful today, mixed as they are with a false sense of modernity and packaged as medical necessity. Take the insistence upon the ‘sitting month’, or ‘golden month’, a period of 41 days of bed rest for women post childbirth. In a rural society in which women did much of the field work, this was a precaution against infection, and a way to save women from being forced back into manual labour too soon. Parallel practices existed in western Europe, such as the Biblically derived idea of the ‘churching of women’, a blessing given to mothers 40 days after childbirth, which metamorphosed into the ‘lying-in’ or ‘confinement’ of the 19th century.

By the 1940s, Western gynaecologists — newly aware of the dangers of thrombosis caused by immobility — abandoned confinement. Meanwhile, in modern China, the practice was elaborated: not only are there numerous taboos derived from TCM theory, such as that new mothers avoid cold water and raw foods, but the spectre of cancer is invoked to threaten non-believers. ‘My mother didn’t undergo confinement,’ a former colleague in her 30s told me tearily. ‘And that’s why she died of cancer so young, just 15 years later.’ A fear of the modern has crept in, too: new mothers are told to avoid even showering or watching TV.

Another resurgent practice, one that we saw Zhang Mingjuan fall victim to at the start of this essay, is the giving of ‘TCM injections’, which offers the double placebo of supposed herbal benefits with the reassuring presence of the needle. This practice was heavily pushed in the 1980s when the government was keen to promote TCM. According to Fan Minsheng, a professor at the Shanghai University of TCM: ‘During that time, before they put those TCM injections to the market, they didn’t go through the testing processes that Western medicines were subject to.’ In 2012, TCM injections caused more than 170,000 cases of adverse drug reactions, according to figures from the Chinese authorities.

Indeed, the most obvious harm done by TCM is the side effects — and the abysmal failure of both the industry and individual doctors to warn patients about them. It’s routinely claimed that TCM has either fewer side effects than ‘Western medicine’, or no side effects at all; the first is at best unproven, the second is an outright lie, but it is the one most often spouted by experienced doctors nonetheless. Sara Nash, an Israeli grandmother, recently spent a week undergoing TCM treatment for chronic back pain in Hong Kong. However, even she baulked when the doctor prescribed a range of herbal medicines insisting that not only were there no side effects, but there could be none.

In reality, conventional hospitals often find themselves dealing with the side effects of TCM. ‘I personally see at least one person a week with side effects from TCM,’ one doctor working in a major Beijing university hospital told me. I have myself witnessed a friend’s bruised foot swell so grotesquely after he was given TCM that it looked like a special effect from Alien. As a result, he was laid up for two weeks in a conventional hospital. My colleague Kath Naday suffered partial paralysis of her throat and stomach after her diarrhoea was given the TCM treatment, which caused her unspeakable agony until she vomited up the drugs.

Even worse damage can be done by the outright fraudsters who hang off the fringes of TCM. Hu Wanlin was in prison for manslaughter when he opened a medical practice in 1993. Upon his release in 1997, he set up hospitals in the Shaanxi and Henan provinces. His remedies, which contained lethal doses of sodium sulphate, were suspected of killing 146 people in the Zhongnanshan Hospital of Shaanxi alone, and in 1999 he was finally arrested. He is now serving a 15-year sentence for murder.

Shamefully, if unsurprisingly, China’s mainland government has done far less about issuing alerts about dangerous or toxic TCM treatments than the authorities in Hong Kong and the UK. To pick a few examples from the past four years, Anshen Bunao Pian pills, used for treating insomnia, contain 55 times the Chinese mainland’s legal limit for mercury. Zheng Tian Wan, a popular migraine treatment, is packed with aconite, causing potentially fatal heart palpitations and kidney failure. More than 60 per cent of China’s TCM products are blocked from export, according to the World Federation of Chinese Medicine Societies, a government-approved industry group.

Where can we go to buy animal parts?’ he asked me conspiratorially, ‘Tiger, eagle, snake? For medicine! For men’s health!’

Around 30 to 35 per cent of TCM drugs, according to UK and US studies, contain conventional medicines. One of the Beijing pharmacists I spoke to, a thoughtful middle-aged man, freely confirmed this. ‘The Western medicine is so that people get quick relief,’ he told me, ‘But then the Chinese medicine treats the long-term issues they might have.’

Yet he couldn’t tell me exactly what conventional products were contained in the TCM drugs he sold. The conventional ingredients are unlabelled, often in doses far in excess of the norm, or combined with substances that should be available only by prescription. Painkillers are most common, but TCM skin creams often contain powerful steroids that are harmful to children. And in an effort to recapture the market, modern TCM erectile dysfunction products have been found to contain four times the usual dose of Viagra’s competitor Cialis.

The quest for magical ingredients in TCM has also taken a heavy toll on Asia’s wildlife. TCM institutions have officially discouraged the use of endangered animals, but the practice continues even among those who should know better. In 2003, I took a group of Chinese Buddhists to a conference on Buddhism and the environment in Ulaanbaatar, Mongolia. One of them took me aside the day they arrived. ‘Where can we go to buy animal parts?’ he asked me conspiratorially, ‘Tiger, eagle, snake? For medicine! For men’s health!’

The official answer to these problems is further ‘scientification’. Most new government money for TCM goes to ‘scientification institutes’, and hundreds of TCM trials are published every year. But as the anti-TCM campaigner Zhang Gongyao said: ‘The so-called scientification of TCM has been going on for 80 years now, and still has no positive results. Some researchers want the chance to get more money from the government, and scientification is a good target for that.’

Yet scientific, or even ‘scientificated’, treatments might not satisfy the same emotional or symbolic needs that TCM does. The active ingredient in bear bile, ursodeoxycholic acid, has long been identified, synthesised, and proven to be an effective treatment for breaking down gall stones. Yet hundreds of thousands of mainland customers still insist on buying costly bear bile products produced through painful extraction from the gall bladders of live bears. They are backed up by officials like the SATCM director Wang Guoqiang, who falsely claimed in 2012 there is ‘no substitute’ for live production. Besides, the magical association with the bear’s strength and the ‘natural’ production are far more significant to TCM users than the actual effects of the drug.

Real proof would need a massive improvement in the rigour of lab work. I am, at best, an interested amateur when it comes to research methodology, but reading TCM trial reports first-hand makes me wince when I come across sentences such as: ‘We set the control group at half the size of the experimental group, because it would be unethical not to have given more people an effective treatment.’ In the TCM trials published on the mainland, negative results are vanishingly rare. A systematic review of TCM trials conducted in 2009 by the Cochrane Collaboration found that most trials suffered from poor or incomplete data, and expressed severe concerns about methodological flaws.

In one review, the mean average of 7422 surveyed Chinese TCM trials on the Jadad Scale (a standard measurement of quality) was 1.03 out of a possible five, excluding the vast bulk of them from inclusion in clinical reviews. Another assessment, conducted entirely by Chinese researchers, found that only four per cent of some 3000 TCM trials surveyed used adequate methods of blinding and allocation concealment.

Edzard Ernst, emeritus professor of complementary medicine at the University of Exeter, said that ‘the most fundamental problem is that TCM researchers use science not to test but to prove their assumptions. Strictly speaking, this amounts to an abuse of science. It introduces bias on all levels and to such a degree that it is often impossible to identify on the basis of the published research.’

I was told of one TCM case at a provincial university in China where a PhD candidate was instructed by her supervisor to test whether a particular remedy he was keen to promote impeded cancer in rats. When the rats proved as cancerous as ever, he forced her to fake the results.

Poor methodology, aside, there’s a more fundamental, philosophical problem: if traditional Chinese treatments or medicines are proven to work, then they stop being TCM and simply become part of the corpus of global evidence-based medicine. And as Yu Hsien, a doctor writing (pseudonymously) in 1933, aptly noted: ‘The day Chinese medicine is scientificised is the day it becomes cosmopolitanised.’

For me, the vision of sifting the vast range of traditional Chinese treatments through the sieve of evidence — sorting placebo from non-placebo, discerning active components, becoming aware of side effects — seems like a heroic national project, one that would put China on the scientific map and benefit all of humanity. But the idea of applying rigorous evidence-based methods, ultimately eliminating the idea of a separate TCM itself, is unacceptable to institutionalised TCM. ‘Among the scientification researchers, most of them have been refusing to conform to the “Western norm of science” in their lab results, for it is thought to be “unsuitable” for TCM,’ Professor Zhang Gongyao wrote to me, frustrated. ‘The researchers of TCM have no interest in eliminating the placebo effect in their lab work.’

There are also claims that standard research methods simply aren’t applicable to TCM, because ‘the treatment must differ for each individual’, or because ‘a suitable placebo can’t be used’. This massively underestimates the ingenuity of evidence-based researchers in designing robust, reproducible lab tests. German researchers devised a ‘sham acupuncture’ needle in 2001, allowing a plausible placebo, while there have been numerous tests incorporating individualised herbal treatments. ‘There are many adaptations of the trial design which allow us to incorporate virtually all the needs of TCM,’ Edzard Ernst has noted.

Other practitioners still have genuine philosophical objections to the idea that ‘Western metrics’ must be the only measure of medicine. But both in my wide reading and in some teeth-grindingly frustrating conversations, I have never heard or seen a plausible alternative heuristic proposed.

The most common suggestion is that Chinese medicine is simply and purely ‘empirical’, that its efficacy can be judged from experience and practice. It all depends on the jingyan, the ‘experience’ of the doctor, individualised and localised, and passed down from master to favoured apprentice. It ascribes an almost magical intuition to the wisdom and skill of individual doctors, while ignoring the measurable realities of treatment.

And yet, in turn, that experience shouldn’t be dismissed. Whatever the failings of TCM, the skill of individual doctors in dealing with and reassuring patients, if not always curing them, is often visible. When it comes to the lives and health of ordinary Chinese people, the individual experience of good TCM practitioners could be a valuable resource for doctors, both in spanning cultural bridges and in pointing up everyday factors and beliefs that might hinder or benefit treatment.

But this, like the other good things within TCM, cannot be done as long as the pretence that TCM itself is a valid scientific theory continues. Chinese traditions can be wonderful. They can give everyone, not just the Chinese, ways of thinking about how we live and how we see our bodies, and about our relationships with the world and each other. Chinese medicine could be wonderful, too. It could draw upon a rich history of experimentation and curiosity, a broad pharmacopoeia, and a deep concern for the poor and vulnerable, all tempered by modern methods. Both could enrich humanity and be a source of valid national pride at the same time. But for that to happen, Chinese tradition and Chinese medicine alike have to be cut free from the carcass of TCM.

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Comments

  • Michael

    Now, from what I know, and I came from China, LuXun's Medicine is a metaphorical story about finding a cure for the ailing country, which is China. The medicine described is education so as to achieve a stronger and better country. The jabs that he took at the traditional belief of unconventional cures were aimed at folklores and not at TCM.

    Furthermore, most, if not all Chinese doctors advise patients not to combine TCM and Western medicine without prior consultation. And most of the time when people do consult doctors about combining TCM and Western medicine, the answer will most likely be a NO.

    While I agree that some TCM might cause more problem that cure, I believe it is due to the malpractice of the prescriber or doctor. Just like how there are malpractice cases within Western medicine, there will be malpractice in TCM cases.

    Also, you have only expressed only the anti-TCM community's comments. What about results that are for TCM? If TCM is as bad as you made it to be, then it causes me to wonder why the Chinese population so large now. TCM could have killed us all long ago.

    And whether you like it or not, Western medicine has not only revolutionised healthcare, it has also led to the mutation of thousands of different species of germs and viruses.

    • James Palmer

      Uh, Lu Xun is pretty explicitly against Chinese medicine, based on both his own family history and his ideological beliefs - the idea that this can be reduced to being against "folklore" is a gross historical distortion. I can give you direct quotes if you'd like, or you could look them up yourself with five minutes of effort.

      The rest of your post is equally full of misstatements (Western medicine and TCM are combined all the time) and fallacies (if African traditional medicine doesn't work, why are there so many Africans). Plus, of course, the normal assumption by the defenders of "alternative" therapies that if you go after pseudoscience and false treatments, you must be absolutely in favor of everything that "Western" medicine has done ever.

      And, of course, this bullshit notion that because you come from China, you're in any way qualified to talk about everything Chinese ... sigh.

      • Michael

        I would advise you to study the literature meaning behind LuXun's works. Most, if not all of his works contains sentences with more than double meanings. And nowhere in my post did I say that Western and TCM are combined all the time.

        TCM is a complicated process of measuring the amount of medicine to administer. It is the balancing of the well-being of the entire body.

        Let me ask you Mr Palmer, when someone has liver failure, what other parts of his body are affected? The treatment has to start from the liver right? Addressing the other parts affected is treating the surface and not the root of the problem. That is what TCM aims to achieve - treating the root of the problem.

        Furthermore, in developed countries such as Singapore which has one of the highest standards of healthcare in the world, TCM is becoming increasingly valued, together with other Asian traditional medicines. The Singapore government supports the efforts to promote and investigate further into TCM and other Asian traditional medicines.

        Also, in your post, you mentioned that the efficacy of TCM is dependent on the experience of the doctor, or physician if you prefer, but isn't that the same for Western medicine? Would people trust a fresh graduate to conduct a complicated surgery?

        However, I fully agree with you that the ethical conduct of the researchers of TCM in China should be improved. But as an editor and an author, it would be nice of you to present both sides of the argument and not sound biased against TCM as you are in your article above.

        • Michael

          I also agree with the fact that there are severe limitations to TCM. No one will go to a TCM practitioner if he has a broken bone, heart failure or the like.

          • Kevin McCarthy

            The limitations are that there are no reasons to go to a TCM practitioner unless you can't afford real medicine and you want to lie to yourself about being cured.
            There are probably a few plants that are used in Chinese medicine that have medicinal properties, but surrounded by a mountain load of hocus pocus.

          • Powerlurker

            And most of the ones that do work become a normal part of the western phamacopeia, see: http://en.wikipedia.org/wiki/Trisenox#Medical_applications

        • Tom

          "I would advise you to study the literature meaning behind Lu Xun's works."
          You may find it helpful to read Lu Xun's introduction to Na Han, where he sets out the matter quite plainly.
          You can read it online here: http://www.gutenberg.org/cache/epub/27166/pg27166.html

      • http://www.livinginthehereandnow.co.za/ beachcomber

        "bullshit notion" Ad hominem .... you instantly dropped any credibility.

        • Gyrus

          Not really ad hominem - I assume he thinks the person may be fine, even if he thinks this notion they have is bullshit.

          • http://www.livinginthehereandnow.co.za/ beachcomber

            that's stretching the intention somewhat ...

          • Gyrus

            Don't want to get into nit-picking, but the whole point of condemning ad hominem attacks is that they attack the person, not the idea. And this was clearly an attack on the idea - the "bullshit notion". Swearing doesn't make it an ad hominem attack.

    • damahoho

      > If TCM is as bad as you made it to be, then it causes me to wonder why the Chinese population so large now.

      Because of the adoption of modern high-yield crops and farming techniques, modern medicine, clean water, improved sanitation, etc. China isn't special, the entire developing world has experienced the same population boom over the past century. Even big killers like cancer from pollution cannot possibly reverse the population trend. You have no sense of relative magnitude.

  • Otter

    Great article Mr. Palmer, hope you don't get invited for a cup of traditional Chinese tea now..

    • TwoDog2

      I loved this article, but i'll still be having some tea today.

  • GaelanClark

    Non specific conective tissue...google it and you will find the research from a western practitioner that identifies the routes acupuncture takes through and around the body for curing ailments.

    Now divide 170k by 1.1 billion. The fraction you get is miniscual in comparison to the fraction of children ill affected by vaccines every year in the USA. Where is you big article about Western drug concoctions that kill and retard our children?

    • Kevin McCarthy

      That is an irresponsible and stupid comment. It has been proven over and over again that vaccines do not cause autism (which is what I assume you are talking about). How many people in the world have vaccines saved? Millions, maybe billions. But perhaps you would like to live in a world with small pox and polio.
      As far as acupuncture the only thing that has been scientifically proven is that it is slightly better than a placebo at relieving pain. Hardly something that if widely adopted would revolutionize the world of health.

      • GaelanClark

        Have you ever had acupuncture? I didnt think so.

        So, the article basically goes apeshYt over this fraction....170k/1.1bb=.00015% are mallaffected by TCM. WOW.

        Now, you and every other jack booted "oh the govt is grand" jerkoffs want to look away and wave your hands over this fraction 1/88=.011%.

        End TCM bc 15 in 100,000 have a reaction and when 1 out of every 88 kids who gets vaccinated today will get autism.

        And the IRS and the NSA have some privacy to sell you. Oh you already bought it up?

      • GaelanClark

        When 1 out of every 88 kids who get vaccinated today will get autism you have nothing but contempt for someone who will point it out.

        Oh, and less than 10 years ago the number was 1 in every 130 or so. But who's counting? For you it's just a bunch of retards like your bill maher loves to joke.

        Love that liberal compassion you meathead.

        • Mrs Grimble

          Thank you for that sensible, intelligent contribution to the discussion. /sarcasm

          " 1 out of every 88 kids who get vaccinated today will get autism"
          1) that figure is of children who are *diagnosed* as being on the autism spectrum, regardless of their vaccination status;
          2) autism diagnosis figures have risen over the past couple of decades because the diagnosis itself has been widened.

          But I'm sure you've already been told that, and ignored it because it doesn't fit in with your belief that evil science is responsible for everything that is wrong with your child.

          And I am also sure you're aware that "retard" is a seriously offensive term. Finally, what is a bill maher?

  • Gyrus

    I think your conclusion contains a truth - how TCM (and perhaps other "alternative" treatments) need to stop trying to justify themselves as "scientific". You seem to have some appreciation for the benefits of TCM that - while some have proven susceptible to the validation methods of modern science - remain entangled with a web of belief, imagination, and complex specifics that has been systematically eroded by modern life.

    I totally appreciate your teeth-grinding in the face of not coming across a "plausible alternative heuristic". But to be fair, I think this is going to be one of the biggest challenges for future science - not something to be nailed by the next best-seller. The role of the imagination as an interface between the mind and the body is the key, and while there's some interesting research along these lines, it's hampered by our inheritance of modern science's own superstitions and weird beliefs, formed in its early days.

    Beautiful and intricate as they are, these [premodern] theories don’t correspond with the messy realities of bodies cobbled together by the long randomness of evolution.

    For a start, I don't think we should expect a one-to-one correspondence between imagination and physical reality. It's naive to think that the forms of the imagination that impact the body - be they inner images or socialized ritual practices - will superficially correspond to how the body's cells behave, or what the body looks like when we slice it up.

    But that's not to support the Cartesian idea that there is an absolute gulf between mind and body. Actually, imagination is precisely the faculty that the Cartesian position lacks, the backbone of premodern approaches to healing. (And as you know, evolutionary theory is profoundly anti-Cartesian; the whole mind/body package is non-dual, and both aspects evolved gradually. There should be no surprise about the mind's crucial role in the body to a Darwinian.) We conceptualize imagination, as the "bridge" between mind and matter, antiseptically as "placebo", and perpetuate the Cartesian inheritance by trying to eradicate it from our experiments.

    The researchers of TCM have no interest in eliminating the placebo effect in their lab work.

    There may be an element of "bad science" in this. But equally, on the part of this frustrated comment, there seems to be a confused lack of understanding of the imagination's role as a connective medium between thought and physicality. I'm not sure what "scientific" protocols would look like that appreciated, with no trace of patronization, the links between "placebo" and "magic", but I sense that this is an interesting and valuable challenge to face.

    You hit a major issue when you say that the insights of TCM are "not a basis for ... reproducible treatment." I understand the necessity of reproducibility in modern science. But this is where modern science itself falters in corresponding "with the messy realities of bodies cobbled together by the long randomness of evolution." Not to mention the messy realities of these bodies, not as isolated specimens, but as nodes in a tremendously complex living network of other bodies, material flows, social interactions, beliefs, and dreams. Cleaving unswervingly to reproducibility is obviously the rock-solid strength of the scientific method. But a price is paid; bits of reality are always omitted. I don't have unreserved faith in the unquantifiable wisdom of the experienced individual traditional healer; but I recognize this element in premodern life, and its potential for sophisticated responses to complex, individual pathologies that will never be fully grasped on the Procrustean bed of systematic experiment.

    There's obviously a catch-22 at work. To the extent that imagination is effective at the bodily level, it is supported by webs of social belief. Traditional approaches are thus hampered by the general erosion of traditional social beliefs created by modern individualist secularism. As demonstrably effective as many modern treatments are, they themselves are bolstered by the generally invisible "placebo" of science's trappings: the "clean, organised" atmosphere, the "foil packets and shiny capsules". Hence, of course, the efforts to "scientificate" TCM.

    But many people's imaginations are still stimulated better by the cluttered alchemist's den. It's hard to see that vanishing, this side of swapping our messy flesh for silicon. Bubbling alembics and crowded shelves of strange substances actually correspond more closely to the inner realities of the body than do electric centrifuges and neat rows of test tubes.

    Anyway, thanks for a fascinating article.

  • GaelanClark

    Please examine my below listed exclamation......

    The fraction of TCM related contra indications to herbal remedies is only a fraction of deaths and cases of autism and other contra indicated maladies resultant of vaccine usage in the USA today.

    So...a fraction of a fraction gets your litany of disfavor...and yet the children mal affected by vacci es provided from Western medicine gets a "lets look the other way" treatment.

    WOW WOW WOW

    • James Palmer

      And the inevitable anti-vaccination bullshit comes out - it's depressing how charlatans and fools flock together in defense of their pet causes.

      • Gyrus

        It's equally depressing how skeptics reflexively take their worst opponents on, instead of dealing with more sophisticated counter-attacks.

        I appreciate your comment was probably intended as dismay at how valid TCM stuff is muddied by ill-informed support. But as with Dawkins' atheism, there is a tendency among the proponents of modern science to hold their most easily dismissed opponents as representative (instead of accepting them as merely loud).

        • James Palmer

          This is the thing. There's nuanced and intelligent cases to be made for various types of alternative medicine. But when the majority of people defending it squawk the same poisonous (and deadly) nonsense like the massively discredited autism=vaccine claims, or the same old bullshit about "nature," or the same old claims about "Western medicine," it becomes a little tiring to deal with them, and much harder to find the intelligent people on both sides.

          That said, I'm equally annoyed with unnuanced (and often unthinkingly sneering and Western-centric) claims about "woo" from some people ...

          • Gyrus

            Yep. Tough standing your ground in that grey area called "reality"...

  • rameshraghuvanshi

    Real tragedy is traditional Chinese medicines never scientifically tested in laboratories.,what are ingrain in them how they effect on disease ,they are carry on blindly centuries after centuries..Now China is industrial country must test all traditional medicine scientifically and they allow to use them

  • James Palmer

    Should also mention my gratitude to my research assistant, Yuan Ren, and to various books, particularly Benjamin Elman's history of Chinese science.

  • James Flowers

    James, many of your assumptions are based on old arguments that I prefer not to revisit. I suspect, though, that you have erected a few straw men to tackle a difficult question. For example, the bear bile problem is widely acknowledged by most Chinese medicine practitioners. Furthermore, to quote Wang Guoqiang only serves to show us what a CPC functionary thinks, or how the party/state thinks, who I would argue are not representative of all Chinese medicine practice. Even though you attempt a historical perspective, I think you are targeting the entity that has been created by the party/state in the peculiar attempt to do top-down "TCM." You have also decided on a dated definition of science which discounts local practice. I suggest that science is changing and not fixed. For example, numbers of systems biologists are beginning to accept Chinese medicine as something that parallels their thinking. I will leave it there except to suggest that you are mistaken about Korea. Even if Western medicine is deeply institutionalized in South Korea, so is Traditional Korean medicine. If you went to Korea and could read Korean, you could not miss the ubiquitous and numerous Korean Medicine clinics that line nearly every street. James

    • damahoho

      > For example, numbers of systems biologists are beginning to accept Chinese medicine as something that parallels their thinking.

      Yeah, and the Bible says the universe has a beginning, JUST LIKE THE BIG BANG! (sarcastic) What does you sentence even mean?

  • nadia

    I agree with Michael's comment.

    I grew up being healed with homeopathic medicine, used antibiotics when necessary : to be protected from infections after tooth extraction for exemple.

    I didn't get all the vaccins that are recommanded nor obligatory. That was my education...not my choice.

    Now, I'm an adult and so far, I thank my mother for her choices and I became even more radical I guess. I haven't taken any medicine for four years, of any kind. When I'm sick I first do my best to purify my body...drink hot water, eat well, listen to my body. (It doesn't mean that I'm not going to go to a doctor anymore..;that would of course be silly)

    The last weird illness I had 4 years ago was cured almost instantly with acupunture. I went to what seemed like a serious center in thailand (Chang Mai, I was on trip there)

    We learn everyday about the abuse of prescription of antibiotics and anyone could observe over the years the strengthening of very common viruses such as the flu virus.

    There is a real pharmaceutical lobbying problem in Europe and USA, that spreads out its influence around the world. It IS a world issue.

    I think everybody has to try to become wiser and not let themselves be taken for a fool by any kind of doctor, traditional, modern.

    There are tons of mistakes made by the scientific medicine approach. One of them being that it is widely dehumanized. Plus, some of it is really inefficient but people feel they have to take it or else...

    Don't idealize it.

    In the same way, the craziness around the miraculous concoctions of popular chinese medicine, not prescribed by doctors I believe, is really harmful to the planet and animal species...you all heard about elephants, tigers, for exemple.

    I'm french...just to place this in a litlle bit of context.

    Sheers!

    • Kevin McCarthy

      "There is a real pharmaceutical lobbying problem in Europe and USA, that spreads out its influence around the world. It IS a world issue."

      That has nothing to do with the fact that medicine is science (and thus evidence based) TCM is not.

      "We learn everyday about the abuse of prescription of antibiotics and anyone could observe over the years the strengthening of very common viruses such as the flu virus."

      I think you lack a basic understanding of medicine. Antibiotics deal with bacterial infections. Yes there is an abuse of them, and they are over prescribed (les antibiotics c'est pas automatique!) and they create more resistant bacteria. They do not create more resistant viruses as they have no effect on viruses.

      No one is talking about idealizing something. The scientific process is a way to identify medicine that works and develop specific treatment to solve specific problems. Why would you want to take something that can't be proven to work........

      • M Collings

        It might be evidence based but that doesn't mean it doesn't have a credibility problem all the same.

      • orthorim

        The only reason TCM has been with us for thousands of years is because it works. There is evidence spanning generations. And there's people like me who will tell you that yes, it works. I don't know why, but it does. I am OK with not knowing why, but I hope we find out some day. I hope our western science at some point catches up with that.

        As for the scientific method, it's been with us for a very long time. If history shows anything it is that scientific knowledge advances constantly. And it also shows us that our scientists have been wrong about the most basic things in the past. So some humility would do us good, and maybe remove blockages we have for learning new things.

  • winnifred_wang

    I completely agree with the author's point that Western medicine desperately needs a leg up in China. Yet I'm worried that doing so comes at the price of completely discrediting TCM. TCM would be a terrible solution for most illnesses, but its attempt to restore the balance in our bodies is a very valid one. Acupuncture, for example, rests on this theory, and has been proven to work for certain problems.

    Although some TCM claims seem to be absurd, they are found to work by those who follow them. I was particularly struck by the quote "new mothers are told to avoid even showering or watching TV," which was the quote that prompted me to read the entire article. Certainly showering would be plausible a few days after birth; but immediately after heavy blood loss? Probably not. Also, I believe the "not watching TV" practice stems from the experience of the many women who experience weakened sight after childbirth; it's a caution against straining your eyes too much. The main problem isn't really "debunking" TCM as if it were completely mystical, because since TCM has survived so long, it obviously includes at least some elements that work.

    I actually think that Western medicine and TCM should be combined further; finding a happy balance between the two would be ideal. Many writers seem to view the two as contradictory, but in my experience there are an increasing number of people who use both because they see the virtues of both. Oddly tired or have pains that Western doctors can't explain? TCM. Need a flu shot? Western medicine. Western medicine practitioners view TCM as superstition and TCM views Western medicine as invasive and overly reliant on foreign agents. The main problem is that a shift in attitude is needed, on both sides.

    • Kevin McCarthy

      "since TCM has survived so long, it obviously includes at least some elements that work."
      I really don't think surviving for a long time is proof of anything.

      There, I am sure, some plants used in TCM that have medicinal uses. But there is no differentiation between those that work and those that don't. No studies on how to use them, no counter indications, no listing of side effects.
      I am sure if you went back 3000 years and found a small tribe/village in Europe with a shaman you would find that a few of the plants he uses have medicinal applications. Does that mean you can compare it to modern medicine???

    • Mrs Grimble

      "Weakened sight after childbirth"? What's your source for this claim? I'm a mother of four, a grandmother and with plenty of friends with children - how come I've never heard of this? Neither have I ever been told not to shower after childbirth. After all, the bleeding was coming from my uterus, which is difficult to reach with a shower!
      Also, please define "balance in the body". Preferably without talking about mysterious "energies".

  • r_s_g

    Thanks for another great piece James. I've been impressed with your writing in Aeon thus far.

    This notion that science is "Western" or even that there is such a thing as "Western medicine" is incredibly damaging in China. There is no such thing as "Western medicine," only evidence-based medicine. Everything else is at best an unproven hypothesis or at worst quackery. I would add that the majority of "alternative" medicine practiced in the West is equally nonsensical and totally lacking in scientific foundation. If a treatment can be proven safe and effective via properly designed medical research, than it moves from being "alternative" or "TCM" to simply being medicine. "Western medicine" vs. "alternative medicine" and "TCM" is a totally false dichotomy (trichotomy?).

    Your term "teeth-grindingly frustrating" is quite apt to encompass many conversations I've had in China regarding science, whether directly related to medicine or not. For a country that is supposedly pumping out scientists and engineers at a rapid clip, the widespread lack of understanding of even the basic scientific method is quite astounding. I, too, have had various conversations with university-educated, young Chinese professionals who believe (1) that Chinese bodies and foreigners' bodies are biologically different (more so than superficial differences like skin color, etc.); and (2) TCM cannot be tested because "Western science" cannot "understand" it.

    However, this lack of understanding of science extends throughout the world and is also prominent in the United States (my native country, where a great many people think the world was created in a week 5,000 years ago and that climate change is a hoax) where "alternative medicine" is fast gaining ground, as is the anti-vaccine movement, both of which are rooted in psuedo-science and chicanery. Once again, the minute an "alternative medicine" treatment can be proven effective, it is no longer "alternative," so by its very nature "alternative medicine" consists of unproven hypotheses (to be charitable).

    Surely, you will have loads of commenters explaining how this or that treatment helped them or their relative. "It worked for me" totally rules out a placebo effect or simply regression to the mean (for many ailments, some amount of people will recover with no treatment). But of course the plural of anecdote is not "data." I can also argue that my iPhone wards off attacks from tigers because for as long as I've carried it, I've never been attacked by a tiger. For that matter, it has also helped prevent me from getting cancer.

    Discounting the scientific method by simply dismissing it as "too Western" or incapable of measurement allows for the possibility of mysticism and the supernatural--effects that cannot be observed or measured but are simply claimed by believers based on their own cultural and personal experiences. That is a world where the biological, physical, and chemical principles constituting a foundation of reality are malleable, a world of snake oil salesman and charlatans hawking miracle cures and bogus religions.

    • M Collings

      I like Science and I imagine most of the world things its pretty useful too.The issue these days is it gets championed as a Religious like superior world view which in many cases clashes with non Western cultural norms and other world views. I think the final passage summed that view up. The non Western world will not be won over by Science with such a Superior attitude

    • orthorim

      Well if only that were true. I am sure the Chinese government is doing all sorts of shenanigans with TCM - James is probably quite right about that.

      But by evidence, I've seen alternative methods work exceptionally well more times than I can count.

      So if a western scientist comes along and tells me "no, this does not work", I can only laugh at them. How petty they are, clinging to their scientific method yet not fully understanding it. Because understanding would imply that they entertain the possibility that there is something they don't know.

      I grew up in 70ies. The scientific state of the art at that time was that mother's milk is not good for babies. Formula is much better. Very clever people in white lab coats said so, so it must be true. As a consequence, my mother's breast milk was pumped off, and I was given formula; at least until my mom had too much pain from the pumping and my father stopped the nonsense, reasoning that "something that's worked throughout humanity can't be all bad".

      My feeling 2013 is the 70ies as far as western views of TCM are concerned. Un-informed, kind of clueless, really. But convinced of infallibility.

      I hope that in a 100 years, TCM will have its equivalent explanation in western scientific language; that will make both TCM and western medicine infinitely better, because more informed. It's obvious, so obvious that I would be surprised if there weren't many researchers working on it right now.

  • http://www.inpraiseofchina.com/ Godfree Roberts

    Injections are not part of TCM. They are a Western invention and are always subject to the kinds of reactions described here. I've used TCM for 40 years and never had or seen an abreaction. This is just Westernism. Dated Westernism at that.

    • r_s_g

      What is "Westernism?" Can you define that term? And what makes it dated?

      The use of injections is widespread in current TCM practice in Mainland China and the practice has been adopted without scientific evaluation or understanding of risks involved. The majority of TCM injections, like most TCM treatments, have not been subject to clinical trials at all. In fact, Chinese hospitals frequently use medicine, be it TCM or "Western," in manners that are not indicated or are contraindicated. Cold symptoms are routinely treated with injected antibiotics and various TCM which of course cannot cure a cold. These issues are widely reported in Chinese language media and journals. Unfortunately, most Chinese media does not question TCM safety or efficacy. Instead, articles usually conclude that the answer to safety issues is for TCM to be "administered by proper TCM authorities." Chinese FDA oversight of TCM does not evaluate safety or efficacy but only whether murky requirements like "production standards" are up to snuff.

      You can't extrapolate your personal experience into any sort of evidence one way or another. It is just that, personal anecdote. I drive in a car every day and I've never been in accident. Does that mean that traffic accidents do not occur?

  • James Palmer

    I wanted to highlight a really wonderful post over at reddit on the harm TCM can do in practice - http://www.reddit.com/r/China/comments/1g9crq/great_article_on_tcm_as_largely_bullshit/caih2gq

  • TravellerThruKalpas

    One of the biggest problems with science (which does not actually exist in and of itself, since it is merely a reified form of human activity) is that it always has an answer for everything, and judges in the most superficial ways. TCM came about for the same reasons things like chigung and tai chi came about - because millennia ago, human minds were much less distracted and therefore more able to establish connections with subtle realms. The true nature of energy is "other" and was understood much better by older societies, not just Chinese ones, and this knowledge and sensibility has become lost to the modern mind.

    • orthorim

      Interesting thought, do you have some more information on this?

      To me, I don't know. I was raised in an academic household, two grandparents with PhDs in Chemistry, my father as well, and my mom also an academic. I was taught to believe what I see. And I've seen alternative healing methods work so many times that I know without a doubt that they work. Not all of them; there are many charlatans, misguided people, and I have an almost allergic aversion to them. But there are so many real healers as well.

      My introduction to foot massage was a Swiss guy living on the beach in Thailand. He touched my feet for a moment then told me that my left eye had a problem. Nobody knows this as I don't wear glasses and my right eye is just fine so I see normal. But my left eye is nearly blind. He saw it in a second touching my foot.

      • TravellerThruKalpas

        A number of things could be said, but I'll just keep it simple. Visiting with my Tibetan doctor recently, he had only to do a pulse and urine examination, which are used to determine one's current condition, especially as to whether there is merely an energy imbalance, or actual disease. Questions asked about some symptoms I might be experiencing were quite accurate, and the use of medicinal herbal formulas, over several months, was able to help a great deal.

        But there were some aspects (consistent low energy, for example) which were not helped substantially. I had regular tests done in a Western medical clinic, finding "nothing wrong." He said I simply need to ride out my current situation, as it is one of being "energetically challenged" by the current ruling element, and that Western medicine will typically not be able find anything wrong… It relates to five-element theory.

        For example, for the past two years Water has been the ascendant element, and opposed to my natal year element of Fire. Speaking metaphorically, fire is a "friend" to water (think cooking) but water is not a friend to fire (puts it out) - so there is a corresponding condition that can manifest - as actually experienced - wherein the meaning of the five elements lies deeper than just the metaphors used, but which are useful nonetheless in creating a system of understanding and application. Unsurprisingly, Western medicine will not be able to help with these kinds of issues… and these issues are real ones.

  • John

    Healing only takes place within the person. What activates the healing process whether through voodoo, needles or drugs remains a mystery. The science of medicine is largely the science of biochemistry, therefore diseases are studied as a biochemical dysfunction, the solution then resides in a biochemical intervention, drugs. This is a very limited perspective, and does not address the multiple dimensions in the way someone suffers, given a disease label. So, who is to say one system is better than another, its what works that counts. I am speaking as a medical professor of almost 40 years and founder of an Integrative Medicine Center at a University Medical Health Center.

    • TravellerThruKalpas

      "Healing only takes place within the person." Yes and no. Yes, to the extent that there is someone who needs to be healed. But no, because the person is actually "bigger" - or rather beyond - the confines of what one takes a physical person to be. There are subtle bodies involved, which is actually why something like homeopathy works (much to the consternation and denial of western scientists) since it is working on that level.

      • Christopher Carr

        Homeopathy works? The evidence is to the contrary.

        • TravellerThruKalpas

          What evidence? Scientific evidence is "rigged" by its own self-made limitations -- that is, merely human limitations. People who exclusively adhere to those limits will not be able to determine much beyond its narrow scope of discernment. From personal experience, I know that homeopathy works. If you need a somewhat scientifically oriented explanation of why it does, you can get a fairly good idea in Amit Goswami's "Quantum Doctor."

    • Christopher Carr

      Ugh. That such a sloppy thinker is a "professor" of something quite discredits the subject.

  • thisistheotherjess

    On the percentage of MD-awarded doctors: China largely follows the British tradition of medical education where doctors receive a MBBS or equivalent, and where the MD is a higher, research degree regarded to be on par with a PhD. This is also the case in many Commonwealth countries. The relatively low percentage of MD's is not reflective of the education or training of Chinese doctors, who must complete 5-6 years of university education and another 1-3 years in-hospital as standard to receive their medical qualifications.

    It is not, as it may otherwise seem, as if there are BSc biology majors practicing medicine in Chinese hospitals.

    • James Palmer

      This is absolutely untrue: there are absolutely BSc biology majors (or the equivalent) practicing as doctors. Most Chinese "doctors" in hospitals have three to four years of university education and minimum clinical experience. All this is readily obtainable through Ministry of Health documentation, or simply by asking at hospitals. The situation in the big cities is somewhat better, but in the countryside in particular it's appalling.

      • thisistheotherjess

        Not to hijack the topic away from TCM, but could you provide a link, please? I have some experience at Chinese hospitals (albeit, mostly tier three hospitals with extremely eager PR staff) and thought I knew the system reasonably well.

        The educational requirements I mentioned are accurate. It's a minimum of six years to become a licensed physician, and the MD is not the qualifying degree to practice medicine.

        There are, yes, medically underqualified staff working at hospitals who patients will respectfully refer to as "doctors," but they are mostly glorified paramedics and do not operate with the same authority as licensed professionals—their deference to hierarchy being a constant bottleneck in China's infamous hospital bureaucracy. There are three-year university medical courses, where the bulk of these quasi-physicians are drawn from, but again, they are not recognised doctors.
        Anecdotally, I have never encountered a four-year degree holder, sans nursing, working in medicine in a Chinese hospital. And that's likely due to the fact that the pathway to medicine in China is not a postgraduate effort, so completing a degree in anything else besides medicine will only bring one further away from it.

        But my intention in raising this issue was to highlight the differences in medical accreditation, especially when compared to the US. To an uniformed reader, Australian hospital statistics would similarly appear as large, quack-filled buildings.
        To the relief of some, Chinese hospitals are not staffed by a guild of barber surgeons, as that figure of 15% might otherwise forebodingly indicate.

        • James Palmer

          You're looking at a very small top-tier group of hospitals. This - http://archives.who.int/tbs/ChinesePharmaceuticalPolicy/English_Background_Documents/ArticleReprints/Healthhumanresourcedevelopment.pdf - has a convenient but somewhat out of date table showing the qualifications theoretically needed at various levels; in practice these qualifications are frequently ignored at anything outside of tier one hospitals. I've got some Chinese links at work if you'd like.

          The majority of doctors are still in the rural or small-town healthcare system, where qualifications needed are minimal, but even within the big cities I've encountered numerous under or poorly-qualified doctors. I think the problem here, too, is that "doctor" is used pretty shadily - the quasi-physicians you talk about are counted as doctors by most patients, and by the MoH when they're promoting health statistics. ("Engineers" has the same issue). And the residency requirements even for tier-one doctors are not universal.

          • James Palmer

            But you highlight an important issue - bureaucracy. (Another point: virtually *everyone* in Chinese hospitals, even office staff, wears white coats to give a false sense of status.) The multiple hospital tiers and various levels of "doctors" are another burden in delivering decent healthcare through the conventional medical system - confused by the vast numbers of administrators who also clog up the way things function. Also doctors of all types are massively underpaid and seen as low status - for the five-year medical courses, only 17 percent of graduates actually go on to become practicing physicians. And then we haven't even gotten onto the role of big pharma, which is massively corrupt, and how doctors frequently overprescribe in order to get kickbacks from the pharma companies. It's an unholy mess.

          • James Palmer

            V. good summary of these issues here (going thru my bookmarks ...) - http://donaldhtaylorjr.blogspot.com/2009/07/day-2-peking-university.html#comments

          • James Palmer
      • orthorim

        I have no problems with attacking "TCM in China as promoted by the state".

        Just don't throw the baby out with the bathwater, TCM, and derived medicine works very well.

        I guess fire cupping is a good example - because you said in Korea, TCM is marginal, a friend living there told me that when he goes to the gym, he sees the marks - 7 red circles - on the backs of almost all Korean men. Do some research - it's very common in Korea.

  • TCM Supporter

    James: please explain why Thalidomide, a product of western medicine, caused so many handicapped babies. Please also explain why oxycontin, a very recent product of western medicine, caused so many scandals and even criminal prosecutions (see here: http://www.npr.org/templates/story/story.php?storyId=12131233). If western medicine is great, why would the above sad stories even happen? what really went wrong with western medicine?

    • James Palmer

      Because it wasn't tested properly. Attacking the failings of Western medicine, which have been many, though far less than its successes, won't make TCM look any better, you realize.

    • David Fong

      Both the cases of thalidomide and the overuse of medications like oxycontin are indeed very sad episodes in the history of Western medicine.

      There is a heroic component to this as well, since the problem of thalidomide contributed to the widespread testing of medications before they came to market, so that every medication in a Western formulary has a pregnancy-hazard estimate (in Australia - Categories A, B1, B2, B3, C, D and X) based partly on animal experimentation and, just as importantly, post-market surveillance. Do a Google search on any Western medication released in the past five to ten years, and you will find Government/official categorisations, drug company laboratory testing data and warnings, theoretical considerations and often some level of post-market case reports and studies regarding pregnancy risk. In Australia, as both a physician and consumer, I can ring a women's hospital and talk directly to a pharmacist to discuss both theoretical and practical aspects of use of a medication during pregnancy.

      Do the same Google search, or paper literature search) for a herbal medication, and often the best you will find is a theoretical risk estimate; and that theory may not be based on the same medical system that you personally subscribe to.

      The use of 'single-component' medications, common in Western medication, even if patients end up on a dozen of them!, has been followed up in post-market surveillance to the extent that problems not found in trials among a thousand patients have been uncovered when used by tens of thousands of patients. Regrettable, but also an achievement in both the system used to report problems with medications and the use of statistical analysis in what are often very different patients, with different problems, taking different combinations of medications.

      Having a system where we can find problems with the way we do things is not evidence that the system is wrong. Indeed, having a system where a problem exists, but is not recognized or quantified, is a far greater 'wrong'.

  • kololodo

    Today in china, less than 60-year-old Chinese medicine, mostly pseudo-medicine

  • Eric MacKnight

    Western docs could not do anything for my asthma, which after 20 years was getting worse. So I went to the TCM hospital, was off my inhalers in a week, and three years later I have been off all medicine since November, and I am breathing freely in mid-June.

    Pills? Injections? No. And I would be careful with mom-and-pop operations. But western medicine never claimed to be able to do more than treat my symptoms, and failed at that. So don’t tell me that TCM is bunk.

    • orthorim

      This story is not unique - it's repeated all over the world, every day, millions of times.

      What makes me angry is that there is a majority of proponents of western medicine which still pretends that it doesn't work. They make up stuff - it's "placebos", or "psychological". That's BS - if it works, it works, if you don't know why, find out!

      Personally, I use foot massage; that this works is a no-brainer. Hell, anybody can try it and see it working. It's not magic.

    • James Palmer

      As one has to point out over, and over, and over again, your anecdotal evidence is of zero value, thanks to the power of self-delusion, regression to the mean, the placebo response, and good old fashioned coincidence. Please produce the double-blind, rigorously conducted tests showing TCM treatments are effective for your condition.

  • Cheng Zhang

    I have read an article about Traditional Chinese Medicine
    http://www.aeonmagazine.com/living-together/james-palmer-traditional-chinese-medicine/

    I would like to thank you for the author's detailed observation and deep
    insight. However, I think I need to clarify something:

    1. The concept of "Traditional Chinese Medicine" has been misused by some
    people in some place. Some of the practitioners do not have qualified medical
    certificates. Some administrations are employed before being fully proved to be
    applicable to all population.

    2. However, individual cases cannot negate the efficacy of Traditional
    Chinese Medicine. It is a broad and profound medical treatment inherited from
    generations to generations. Dates back to ancient China, a large volume of books
    have been used by people from different classes and its effectiveness has been
    widely recognised. To name but a few, the following books can be a cornerstone
    at each stage of the development of Traditional Chinese Medicine (e.g. "Huangdi
    Neijing", "Compendium of Materia Medica")

    http://en.wikipedia.org/wiki/Huangdi_Neijing
    http://en.wikipedia.org/wiki/Bencao_Gangmu

    3. The distinctiveness of Traditional Chinese Medicine is that it aims to
    treat the disease by using a complex of natural herbal medicine to
    comprehensively adjust the overall metabolism. Compared to the abuse of
    antibiotics and other radical ways, it is more of a gentle, long-cycle-period
    remedy to direct a self-regulation of patients themselves. It also covers the
    lifestyle when dealing with the disease, e.g. diet.

    4. Certainly, there are many cases that Chinese Medicine is not able to deal
    with. Compared to Western Medicine, the disadvantage of Traditional Chinese
    Medicine is, it cannot well characterise the exact effect of individual drug
    elements as well as their interactions during the treatment. That is the main
    reason that there are few formulations of Chinese Medicine being authorised by
    Western medical organisations (e.g. FDA). Therefore, Traditional Chinese
    Medicine needs to be modernised, with not only modern research technique but
    also modern management system.

    5. This article has confused the superstition, prejudice of Chinese Medicine
    with the proper use of that. Too many other irrelevant aspects (history,
    politics, economics, etc.) have been mentioned, which left me an impression that
    Chinese people have an irrational worship for Chinese Medicine. Of course, it is
    not the real case. The real case is, too many other aspects have limited the
    healthy development of Chinese Medicine. All we want to achieve is to
    incorporate useful things and make the best use of them. Let's use our
    collective power to make it a better world to live with fewer patients!

    • Su

      1. Agree.

      2. The fact that TCM is passed by generations does not give any credit to its effectiveness. BTW, do you actually believe the knowledge from those 2 books? Those are not serious medical books.

      3. The "overall metabolism" stuff is nonsense. Medical treatment is science, and we cannot draw any conclusion until the effectiveness and safety of the treatment are proved by precise experiments, which TCM has little to none. Besides, a large portion of diseases are self-healing in days, so you cannot tell if it's actually cured automatically or by a mysterious "long-cycle-period" via TCM treatment.

      4. First, see 3. Second, if the consequence of a medicine is not clear (or not even tested), how the hell can we use it? Even if it's as effective as you said, we should use it after is is "modernized".

      5. Based on my experience, Chinese people do have an irrational worship for TCM, and TCM is sometimes mixed with superstition and other mysterious and religious stuff in China. For example, you cannot even argue about the effectiveness of TCM in front of most Chinese, even those who are well educated. No offense, but I am a Chinese myself.

  • http://www.livinginthehereandnow.co.za/ beachcomber

    Apart from deploring the use of animals in medicinal and pseudo-medicinal practices, the article offers little in the way of insight other than to observe the dubious ethics of the commercially motivated eastern medicinal group, which could just as well be applied to the western.

    The side-effects, the governmental bureaucracy, the nationalistic posturing, the corruption of practitioners by manufacturers, the overstating of claims, the placebo effect .....

    Transpose WM (Western Medicine) and lifestyle for TCM and very little changes.

  • CT

    "In the hospital emergency room, where she awoke, she was told that quick treatment saved her life from the allergic reaction to the shot — a mixture of herbs and unlabelled antibiotics."

    In the very first example you display the stunning lack of critical thinking and muddled logic that stains your whole crap article. Was is the "herbs" or the "unlabelled [sic] antibiotics" that caused Zhang Mingjuan's reaction? Who knows? Let's just say it was due to "TCM".

    If it were a true life-threatening situation - you can be quite sure that anaphylactic shock caused by the unlabeled antibiotics should be the primary suspect. Having worked in Chinese hospitals for a long time, I can also assure you that Ms. Zhang saw doctors that were western-med trained and did not provide an accurate TCM diagnosis for her condition but instead did the standard revenue-boosting IV drip prescription with an add-on script for a clinically ineffective plant-extract to be added to what was already the wrong western med. This is not TCM. This is western medical malpractice that secondarily involves a pharmacological plant extract.

    • James Palmer

      Uh, you clearly didn't read the rest of the article, such as the part where I talk about how the inclusion of *unlabeled* conventional medicine in TCM treatments - such as the antibiotics - is one of the most dangerous aspects. Whether it was the TCM or the antibiotics, the point is that the lack of labeling and regulation is incredibly dangerous.

      As for your "not true TCM" argument, I've heard this used so, so many times; it's as valid as any "no true Scotsman" argument.

      • YMan

        Lack of labeling has nothing to do with TCM or Western Medicine or any body of medicine, it has to do with regulation and policy. Such issues do not or barely exist in the US where there is a higher standard of regulation.
        "Not true TCM" is a very valid and relevant argument because we are starting to see (in the US at least) PT's MD's and Chiro's claiming they perform "acupuncture" or "dry needling" yet their only training is a 200 hour weekend course. I would argue that there is a difference between taking a 200 hour course and a 2,000 hour course (which Licensed Acupuncturists must complete). You wouldn't go see a cardiologist for a tooth ache, or a podiatrist for a spinal adjustment would you? So why would you see an MD for a TCM treatment? It would be irresponsible to see a practitioner who lacks training in the fundamental theories that are the basis of the medicine. Like seeing an "MD" who did not go to medical school. Simple critical thinking could see the absurdity in that.

      • Su

        I think the point of this example is to show that China's medical system is somewhat messed up, and this mess is due to the lack of necessary knowledge of doctors/patients. The deep reason behind this fact is TCM, which has distorted the rational thinking of both Chinese civilians and doctors. So it's still towards TCM.

        • CT

          "China's medical system is somewhat messed up, and this mess is due to the lack of necessary knowledge of doctors/patients... The deep reason behind this fact is TCM"

          Don't agree. Lack of hygiene, equipment, opportunity, policy, regulation, empathy towards fellow human beings, corruption, wealth disparity, and the other reasons that China's medical system is messed up have little to do with TCM.

          Even out of a hospital context: Walk into almost any roadside medicine store and say you have a stomach ache. Immediately 3 to 5 western meds will be suggested without any differential diagnosis. Then ask for Chinese herbal medicine and again no ddx. No concern of drug-drug or drug-herb or herb-herb interactions with the new meds or the ones the patient may be on. This malpractice has many reasons but again has little to do with TCM.

      • Phyllbot

        I wonder if it's more the Chinese hospital system than TCM. I interned a bit at a Chinese hospital, where doctors were giving out b12 injections like candy. The Chinese hospital system is overcrowded and extremely unhygienic. I saw interns and doctors running around with used syringes, throwing them in the general direction of sharps containers. With about 20 people to see in an hour, a lot of these doctors barely took the time, if any, to read the patient's medical charts. It was a simple "what's wrong?" and "here's a b12 shot". Some hospitals didn't even have hand soap! And I doubt that even a TCM doctor would argue against its necessity.

        • Su

          I agree with you, but that's not the main point argued by this article. Besides, TCM makes it even worse. Even doctors who took regular training still more or less believe in TCM, and they sometimes lack basic hygiene and medical understandings. For TCM doctors, especially those who conduct acupuncture, they actaully do not take the hygiene problem seriously. For example, some TCM doctors use the same needles (for acupuncture) for different patients, without sterilization.

          • CT

            The vast majority of doctors in Chinese hospitals do not believe in TCM, even if they prescribe herbal extracts in IV drips. It's usually just to please the patient and generate revenue.

            Out of the hundreds of doctors I've watched administer acupuncture in China, no one has reused needles. Usually doctors will not even reuse a needle on the same patient.

      • CT

        I did read your entire article, twice. And as I said above, your article is a POS. Your friend and your colleague were mistreated at a Chinese hospital. You blamed "TCM" and pieced together enough numbers, half-truths, inaccuracies, and sensationalist anecdotes to sell an article. It's simply an odd, dangerous mix of sense and nonsense.

        Most importantly, as your reply indicates, you fundamentally still fail to recognize the difference between "TCM" (an internally cohesive system of medicine) on one hand and quite separately western medical malpractice that may involve herbs or acupuncture in Chinese hospitals. Antibiotics are not TCM. Unlabeled antibiotics used to treat a western medical diagnosis is not TCM. Even adding herbs to this mix is still not TCM. It is still [western] medical malpractice due to the lack of policy, regulation, and prioritization of quality care both inside and outside of Chinese hospitals.

        I'm not making a "true TCM" argument. I'm asking you to use your brain and recognize the failed logical leaps you repeatedly use throughout your article. You seem to realize this at some level when you write "Whether it was the TCM or the antibiotics, the point is that the lack of labeling and regulation is incredibly dangerous."

  • JieKang

    my mother also believe in TCM deeply, i remember myself forced to drink herbal brow as a child, I study western medicine in university, i think why TCM can never be science, is because TCM are taught and practiced without critical thinking and cross examination, TCM masters are treated with respect and myth, and their students do not dare to challenge them, so no fresh air blow into TCM,

    • LadyDoc

      That TCM is taught "without critical thinking and cross examination" clearly is written by someone with no knowledge of how the medicine is actually taught and practiced in the US today. It is a 4 year rigorous masters degree. It is not taught in the mountains with an aged Master who no one will question. Research is paramount. A colleague of mine was recently hired at The Cancer Treatment Centers of America - an esteemed nationwide facility. He has a team of researchers working under him and he works side by side with the Oncologists on patient cases. They value his input and his expertise and the results he gets with his clients. Please, find a reputable practitioner and talk with them. You may be pleasantly surprised by what you learn.

      • Yu

        I'm sorry are you talking about TCM study and research in the US? I'm afraid Jiekang is talking about TCM study in China. So your defense doesn't seem to respond to his argument...

        Plus, in China when patients look for a TCM doctor, they think the oldest is the best.
        Generally speaking, In China, whatever one studies, one lacks training in critical thinking, though the situation is improving.

      • Sandra Olkowski

        Please share the published research!!!

  • lili

    老外好像对中医很感兴趣。。 虽然文章看的不太懂。 :)

    • Toxoplasma

      不對, 其實好像看的懂。

  • Belinda McCracken

    Having been a Registered Nurse for 20 years, (16 of those in ICU and 8 of those in.a level 1, trauma ICU ) and practicing Chinese Medicine full time since 2006, I wonder what your motivation is for writing this article. In any field there are good practitioners and poor practitioners. Many of your statements are correct and apply to China. I would love to see an article geared towards Chinese Medicine here in North America. There are independent assays done on herbal products ensuring that there are no pharmaceuticals in the herbal formulas nor are there "forbidden" herbs such as the bear gallbladder mentioned in the article or rhino horn. Thank you for your time.

    • Powerlurker

      Chinese Medicine, whether practiced in China or in the West is still a load of nonscientific, feudal superstition no matter the quality of the practitioner.

  • Toxoplasma

    A fantastic and well-written article. The TCM push back against true and
    aggressive scientification is what is puzzling and discouraging.
    Perhaps instead of looking at TCM as a long-lost, errant pursuit of
    knowledge it should be regarded more as a religion which would explain
    its intransigence towards reason and the pursuit of truth.

  • Chip

    One of the best articles on the subject I have ever read. Wonderful! Does anyone know if it has been translated into Chinese? Thanks!

    有没有人把这个文章翻译成中文?

  • Hyle

    One of my college students--scored 3rd highest on provincial math test--said in class that "TCM has been proven by history." (BTW the login form for these comments was reported "not secure" by LastPass.)

  • orthorim

    I agree that there's something problematic in TCM - that is it should stand up to scientific standards. But having seen TCM in action, and not just working, but working exceptionally well, I also think there's just something (or things) we don't know.

    Calling TCM rubbish is ludicrous in the face of the fact that it works for thousands, maybe even millions, every day. A science that directly contradicts evidence is not much of a science at all, and this is my issue with western medicine, which, as we all know, suffers from its own rather significant shortcomings.

    My wife had back pain so bad I had to drive her to the hospital at midnight. The University hospital in Germany was, as you would expect, a top shelf facility; a young surgeon explained to us that the x rays showed fluid coming out of her spine, and that caused the pain. Back surgery wasn't recommended, however, as it would likely lead to complications, and possibly not fix the problem. He told us to go home and try to rest until it got better.
    The next day, we went to a Reiki master my father knew - a women who'd been practicing Reiki for over 25 years. In a single session, she cured my wife's back pain; it hasn't returned in the past 10 years either.

    I fell ill on a trip to Singapore. Not the first time I ever had the flu, I knew what to expect: A few days of feeling terrible, medicine, slowly getting better. But as I was headed to the Hotel I passed by a TCM doctor's office so I decided to give it a try. I got acupuncture, and a treatment where the doctor would apply suction cups to my back; this would leave big deep red sores on my back as I found out later while showering. The amazing thing was that I felt better instantly. That night when going to bed, I could feel my body energy field literally buzzing. The next day I was perfectly fine, as if nothing had ever happened.

    So I want to appeal to science: Don't give up. If we can't explain these phenomena, or even repeat them in the lab - keep searching. Keep trying. We are lacking knowledge - let's find what makes TCM work, let's describe meridians and the body energy field - which BTW anybody can feel with very little effort - in our scientific language. Every failure is an opportunity. Dismissing these things is un-scientific; and ignorant.

    • TravellerThruKalpas

      Thanks for sharing, good empirical post. In agreement with the need to think beyond the current parameters, I would direct some of those who may interested in looking at physicist Amit Goswami's work, especially his book called The Quantum Doctor. It is by no means the only single source for insights pertaining to alternative medicine, but it is full of germane material which provides some plausible considerations related to the energy bodies of human beings (and for example why homeopathy actually works).

  • starrystarry

    what the auther said is groundless , TCM proved to be useful after so many years of practice . Maybe there exist some flaw ,but so do western medicine. tindividual cases cannot negate the efficacy of Traditional
    Chinese Medicine.

  • starrystarry

    "Calling TCM rubbish is ludicrous in the face of the fact that it works for thousands, maybe even millions, every day. " agree!

  • Michael Hanlon

    There is no such thing as alternative medicine. There is no such thing as Chinese medicine. There is no such thing as traditional medicine. And there is no such thing as Western medicine. Any medicine which makes you better (be it made of dried dodo droppings, penicillin or ground up amethyst) is just that: medicine. Anything else is fraud.

  • ithrandir

    Have you seen before modern doctors looking/checking at your eyes and tongue before he do anything more complicated to you ? That's just TCM, but they won't admit they copied it. They would just re-branded it as a modern practice and teach them in schools.

  • http://belacqui.tumblr.com/ Belacqui

    I got the uneasy feeling that we are too quick to point out the apparent savagery and ignorance of the Chinese, while blinding ourselves from our own. Perhaps we are not really frustrated about the true effects of TCM, but more at the fact that to our western eyes their practice look so foreign, so odd and unfamiliar.

    The author points out the virtues of metrics and reproducibility in scientific studies lying at the core of our method of health care. I suspect that most of us are completely ignorant about the science behind our medical practices. The notion of 'science' we take such comfort in is but an illusion formed by the idea that, should we choose to, the studies are available for our scrutiny. But I doubt that most of us have ever read or cared much about the studies and statistics behind most of the drugs and treatments we subject ourselves to.

    We never do the science ourselves; we generally trust our doctors' expertise as blindly as the people mentioned in this article trust traditional Chinese Medicine. A lot of us might believe that taking Tylenol and NyQuil will 'cure' the common cold, while all it does is alleviate its symptoms. When we look at how Chinese remedies that have no scientific backing are so popular, we dissociate from our minds the recent stories about America's shady practices behind research, marketing, and prescription of antidepressants and ADHD medications. Can we really spotlight the Chinese for obsessing about powdered rhino horns and penises, while we casually let our friends and relatives stuff their children with Ritalin and Adderall?

    What seems rather at heart of the matter is our governing relationships with institutions that care for our bodies, and how much trust we put on these authorities and specialists. This perhaps common is to all cultures in any compass direction. Perhaps as long as we entrust our selves to the knowledge and experience of others, so-called quackery and malpractice will always exist, and people will suffer from them and even die. How the Chinese, struggling to integrate their very long history with the modern west, deal with that is a very complex and fascinating dilemma, and I appreciate the author's insight.

  • Bernard B

    This is a smear article. I've personally used traditional chinese medicine for many issues and found it very helpful on many occasions, including some situations where western medicine did not have a clue what the issue was or wanted to resort to strong medicines.

  • John Ashlin

    Really appreciated the article and feel the balance is about right however I absolutely implore you all to listen to this excellent and shocking podcast from the Guardian newspaper science weekly. It's an interview with Ben Goldacre on his new book Bad Pharma which is a forensic investigation into how the pharmaceutical industry – which invests millions in the high-stakes process of drug development and clinical trials – ensures its products reach the market.

    Goldacre discusses the central thesis of Bad Pharma, that drug development and evidence-based medical research are not working for the benefit of patients and may even be endangering lives.

    Goldacre also explains why he thinks there is a need for more transparency in the patient-doctor relationship and why science journals and regulatory authorities need to rethink the evidence threshold and seek full and open disclosure of both positive and negative drug trials.

    • James Palmer

      Oh, absolutely, Goldacre's book is great, and an important counter to the usual whinging from alternative medicine proponents that their critics are somehow pawns of the medical industry, when, in fact, academic critics of alternative medicine tend to be among the most persistent opponents of bad practice in conventional medicine.

  • John Ashlin
  • sandra c

    I never ceased to be amazed at the bigotry that accompanies those who use the word 'scientific' to attack whatever they cannot understand. The absolute minimum study of what it means to use the word 'scientific' would expose the ignorance and prejudice of articles like these. I suppose what authors like this most seek is the approval not to think.

  • Miquet

    Tylenol is linked to thousands of cases of acute liver failure (see: http://www.nlm.nih.gov/medlineplus/news/fullstory_138793.html) and it is never taken off the market. I don't see why Chinese medicine should be vilified.

  • Some Guy

    I think that good science rests upon testable hypotheses. Most of the arguments in the comments pertains only to the quality of this article; that is offering criticisms to criticism itself. What needs to be done is specific research into the efficacy of traditional chinese medicines. Unless TCM theory can actually be falsified, it is of little value in explaining phenomena and therefore will be of little use in understanding the nature of how a drug acts on the body or vice versa. However, the TCMs themselves might still be efficacious (regardless of the theoretical underpinnings) but this too demands empirical evidence that follows the logic of falsification. In the end, theory and anecdotal evidence amounts to nothing and criticisms of criticisms also amount to nothing. It is important to remain open minded about the potential of TCMs for therapeutic use but maintain an austere sense of skepticism when considering the empirical evidence.

  • Dylan

    This was very insightful and seemingly (didn't see any annotations) well researched. Being married to a Chinese woman and having a baby together, we have had some serious arguments about how best to treat some of our son's ailments. We also live in a tier-2 city as opposed to the big ones that have foreign doctors so we're often left with little alternative to TCM. But if I have to hear that my son is throwing up because "he must have swallowed wind" one more time, I'm going to lose my mind.

  • zhou

    第一,根据CFDA2012年的数据,药品不良反应报告按照药品类别统计,化学药占81.6%、中药占17.1%、生物制品占1.3%。第二,炼金术士的小屋?呵呵,你科幻小说看多了,现代药房不是那样的。

    第三,文中说的那个不叫执业中医师,那叫非法行医,邪教能叫宗教么?这算偷换概念吗?

    第四,公众层面的反对?你可以做普查。我认为公众层面是支持执业中医师和中西医结合的。

    第五,我全家都是执业医师,有中有西,我认为中医和中西医执业医师制度存在弥补了基层医疗的不足。

    第六,作者对中国现行的执业医师制度还停留在民国阶段。

    第七,后面说中医的这个段子写得不错,很有感染性,举个例子把中国学医的这些人都渲染成一批毫无化学和生物知识的白痴,在掺杂点政治,中国人的科学素养确实不高,那?孤证不立?

    第八,新妈妈们不让淋浴和看电视是哪本医学教材里写的,您把民间科学和科学弄混了吧,我在医学院待了这么多年没听谁说过哪个老师讲这个。

    第九,中药注射的双重安慰剂效应,好的,请你把相关文献提供出来咱们再讨论这个话题,具体哪个药,意思是所有中药注射液吗?不过真要说,这是一个值得讨论的话题。

    第十,中药没有副作用这种低能观点作者也用来黑,我觉得毫无必要,稍微有点智商的人也明白不可能。作者太小看中国人的智商了。不过中药的毒性确实值得一说,比如前几年的马兜铃酸,这一点很有必要黑,这是推动现代中医学发展的一个必要的黑点,如果你们发现了,请尽管黑上加黑,让更多的人知道,中药并不是外能的。

    十一,游荡在中医周围的极端骗子和执业中医师不是一个概念,如果我说信仰上帝的人都是极端的神棍,想必也有人不爱听。

    第十二,德国的关于针灸的安慰剂实验,不说德国人,中国人也在做,我每天看到的做针灸治疗的病人有50名以上,持续了10年多,如果真的是无效的安慰剂效应,这个骗局就太容易了,你们都去搞针灸安慰欺骗病人去吧,能挣大钱了,要执业医师做什么?

  • zhou
  • Llena

    Very strong bias in this article. Hope the writer be more responsible to the readers and do more research and interviews on both sides instead of presenting his own biased opinions.

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