The Globalization of Chinese Medicine
The Globalization of Chinese Medicine

Yale researchers recently found that huang qin tang, a Chinese herb mixture, is effective at reducing chemotherapy’s side effects, including diarrhea, nausea and vomiting. Phase II clinical trials for the herb mixture are being funding by NIH’s National Cancer Institute. To ensure pharmacological consistency, Yale researchers developed a biotech company to monitor the herb’s growing conditions.  Huang qin tang, known as PHY906, is a rare example of Chinese medicine that has the potential to go mainstream.1

Most scientific publications require that studies of Chinese medicine follow the same methodological constructs as studies of Westerns ones. This rule gives primacy to Western approaches to medicine. Traditional Chinese Medicine (TCM) is no longer independent, but is viewed within the context of Western medicine.  Chinese medicine has come to be viewed by the mainstream medical community as complimentary rather than the primary paradigm. This role negates the whole concept of Chinese medicine, which is holistic in nature, taking account more signs and symptoms, both somatic and psychic, than Western medicine.2

This analysis will examine the differences between TCM and Western medicine, the historical evolution of TCM, and current debates and challenges surrounding TCM use around the world.

TCM vs. Western Medicine

Western medicine is based Germ Theory.  Diseases are categorized based on physiological systems in which they occur and according to their causes. Treatment plans are based on the symptoms and the causes of the disease. In comparison, TCM is based on observations of natural phenomena as originally described by Daoist masters. Everything is contextualized, nothing exists in isolation. TCM is based on balancing five elements (Fire, Earth, Metal, Water, and Wood). These elements are a variation on the Qi, a bio-electric energy flow through the body along meridians. Lack of energy flow results in disease.3

Reconciling the two systems is challenging because the Chinese approach does not align well with the linear Western approach. TCM is non-technical and qualitative, while Western medicine is technical and quantitative.  The field of bio-electromagnetism (BEM) is one area where the two can be broached. BEM examines the electromagnetic fields underlying life processes. BEM is considered a viable research paradigm in Europe, though is not investigated in the U.S. BEM is similar to the TCM examination of the Qi. BEM treatment plan uses similar points along the meridians as acupuncture.4

Historical Evolution of Chinese Medicine

The TCM practiced today is based on standardization efforts that took place in China in 1950s with the creation of TCM colleges and hygiene schools, hospitals and clinics. The Communist state-building project mandated that TCM institutions be built in every provincial capital. From 1956 to 1963, TCM textbooks were written and TCM institutions were created.5

At the time, China was suffering from the consequences of the Great Leap Forward (1958–1961), including an acute famine. Chinese herbs were available and acupuncture did not require much equipment, and was relatively easy to learn. Thus the promotion of TCM made a lot of sense. The communists though insisted on combining Chinese and Western medicines. Over time TCM treatments subtly adjusted to Western ones.6

The field of TCM experienced a huge loss during the Culture Revolution (1966–1976) when many senior doctors were killed or committed suicide. On the other hand, during this period, the Dictionary of Chinese materia medica was published. In 1978, China reintroduced nation-wide exams to recruit a new cohort of dedicated students. A fifth edition of the TCM textbooks was published in 1985. In the 1980s, while TCM studies grew, it did not receive the same level of financial backing from the state as Western medicine. Urban Chinese tended to consume Western medicine more than TCM.7

In the 1990s, TCM was commodified as semi-private industries promoted TCM in global health markets. In China, TCM colleges became “Universities of Chinese medicine and pharmacotherapy.” Revenue from TCM hospitals in China is expected to reach $25.7 billion in 2012, a 14 percent increase from 2011.8  Major pharmaceutical companies, such as GlaxoSmithKline, have established research and development centers in China, and are researching TCM in hopes of finding the next miracle drug. China Botanic Pharmaceutical is the leading producer of “all-natural plant-based botanical, biopharmaceutical and traditional over-the-counter (OTC) drugs.”9

The Chinese materia medica is now at the forefront of global science, though acupuncture is the most widely spread element of TCM practiced in the West. As of 2007, 3.1 million Americans had tried acupuncture.10  Schools teaching TCM can be found world-wide.

Challenges around the World

Policy-makers around the world find different ways to incorporate TCM into public health systems. The U.S. National Institute of Health (NIH) notes that, “Acupuncture has the largest body of evidence and is considered safe if practiced correctly. Some Chinese herbal remedies may be safe, but others may not be.”11   The U.S. Food and Drug Administration (FDA) regulates dietary supplements, including manufactured herbal products, but these products have fewer restrictions than prescription and over-the-counter drugs. When supplements have been found to cause severe health problems though, such as ephedra (a Chinese herb linked to heart attacks and strokes), the FDA has banned them. The FDA though has not banned TCM remedies or herbal teas that incorporate these herbs.12

Most U.S. states provide licenses for acupuncture, but vary in their inclusion of other TCM components, such as herbs.13  The National Certification Commission for Acupuncture and Oriental Medicine validates entry-level competency in acupuncture and Oriental medicine (AOM) through professional certification, which in turn is accredited by the National Commission for Certification Agencies (NCCA).14

Similar to the U.S. regulatory system, in Switzerland, professional federations have expert bodies to convene minimal training programs for biomedicine and Chinese medicine practitioners. The federations also work with insurance companies to negotiate the terms of coverage for approved professionals for a list of authorized procedures. While in Italy, any TCM practitioner that is not also a qualified doctor must work with a general practitioner to monitor patients. 15

In Australia, scientists and doctors are debating a contentious decision to allow TCM practitioners to be registered with the new national Chinese Medicine Board of Australia. Victoria already registers TCM practitioners.  TCM practitioners include those that make, diagnoses, and dispense herbs and perform acupuncture. The Australian Medical Association notes that TCM practitioners have lower registration standards.  They argue that professional development requirements should be the same as other doctors.  Furthermore, they want English language skills to be required too. The new registration rules are seen as an attempt to address these unequal standards.16  The new Chinese Medicine Board of Australia will register complaints and will be in charge of disciplinary processes as well as assess practitioners from overseas who want to work in Australia.17

One critic, Marcello Costa, Professor of Neurophysiology, Department of Physiology at Flinders University, notes, “Living in a modern society requires that in matters of health, we unapologetically only accept practices that have undergone the scrutiny of science. And once that criteria is fulfilled, we can accept it as effective medical treatment and teach it in our universities. Sadly, this is not the case for most traditional Chinese medical practices and practitioners.”18

Another debate surrounding TCM is its impact on environmental sustainability.  China cannot provide all the ingredients to fulfill domestic and international demands.  Already in Australia, manta rays are threatened because their gill rakers are dried and boiled and used as a TCM health tonic.19   The World Wildlife Foundation (WWF) has worked with the Chinese government to promote alternatives to treatments with animal parts from threatened or endangered species.  WWF is also working to protect the survival of wild American ginseng, a TCM plant that is being unsustainably collected and is listed in the Appendix II of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES).20

Conclusion

Whether considered a complimentary treatment or a primary one, TCM is on the rise around the world. Despite its significantly different approaches to well-being, many people are using both TCM and Western medicine at the same time. While some might view it unfair to hold TCM to the same standards as Western ones, as this implies that Western medicine has higher standards, others will argue that in the end, the consumer needs the same level of protection.

Does bringing TCM under an official regulatory system provide in official legitimacy? Australians fear it will and some doctors do not want to give it that status without further research. In the U.S., regulatory agencies, such as the FDA, allow Chinese herbal therapies and even pay for research, though they are careful to tell consumers that they do not endorse all therapies as there many unknown risks. Further research of TCM remedies can only benefit people worldwide as scientists and doctors begin to understand how and why these 3000-year old treatments work.


1  “Chinese Medicine Goes Under the Microscope.” The Wall Street Journal. April 2, 2012.
2  Éric, MariÉ. “The Transmission and Practice of Chinese Medicine.” China Perspectives, 2011, Vol. 2011 Issue 3.
3  St. Clair, Robert N. and Rodríguez, Walter E. and Roberts, Andrew M. and Joshua, Irving G. “Intercultural Incommensurability and the Globalization Of Chinese Medicine: The Case Of Acupuncture.” The Journal of Comparative Asian Development, Vol.5, No. 1 (Fall 2006).
4  Ibid.
5  Hsu, Elizabeth.”The History of Chinese Medicine in the People’s Republic of China and its Globalization.” East Asian Science, Technology and Society: An International Journal.
6  Ibid.
7  Ibid.
8  “Traditional Chinese Medicine Hospitals in China: Government Support is Accellerating Growth, says IBISWorld.” Times Union. April 1, 2012.
9  “China Botanic Pharmaceutical Deserves A Closer Look.” Seeking Alpha. March 21, 2012.
10  “Traditional Chinese Medicine: An Introduction.” National Institute of Health.
11  Ibid.
12  “Safety.” National Institute of Health.
13  Ibid.
14  National Certification Commission for Acupuncture and Oriental Medicine.
15  Éric, MariÉ. “The Transmission and Practice of Chinese Medicine.” China Perspectives, 2011, Vol. 2011 Issue 3.
16  Griffiths, Meredith. “Standards ‘too low’ for Chinese medicine practitioners.” ABC News. April 3, 2012.
17  Robotham, Julie. “Alarm bells sound on registration of Chinese medicine.” Knox Weekly. April 2, 2012.
18  Costa, Marcello. “Does traditional Chinese medicine have a place in the health system?” April 4, 2012.
19  Sullivan, Rachel. “Chinese medicine threatens Ningaloo manta rays.” ABC. January 25, 2012.
20  Wildlife Trade. Traditional Chinese medicine.

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