TRADITIONAL CHINESE MEDICINE: PHILOSOPHY, SAFETY, STUDIES AND DOCTORS

TRADITIONAL CHINESE MEDICINE

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Tongue analysis
Image source:
acupunctureproducts.com
Traditional medicine depends on herbal treatments, acupuncture, acupressure, moxibustion (the burning of herbs over acupuncture points), and "cupping" of skin with heated bamboo. Such approaches are believed to be most effective in treating minor and chronic diseases, in part because of milder side effects. Traditional treatments may be used for more serious conditions as well, particularly for such acute abdominal conditions as appendicitis, pancreatitis, and gallstones; sometimes traditional treatments are used in combination with Western treatments. A traditional method of orthopedic treatment, involving less immobilization than Western methods, continued to be widely used in the 1980s. [Source: Library of Congress]

The World Health Organization estimates that four fifths of all people in the world still rely chiefly on traditional medicines, mostly herbs and plants. According to AFP Such therapies have been used in China for more than 3,000 years, but have risen in popularity outside Asia in recent decades and now amount to a global industry worth hundreds of millions of dollars a year, according to the study in PLoS Genetics. [Ibid]

Most Chinese hospitals have at least one acupuncturist and herbalist on the staff and dispense more than 300 different kinds of medicinal herbs. The number of traditional Chinese medicine doctor rose from 150,000 in 1985 to 250,000 in 1995 to 270,000 in 2005, while the number of Western doctors rose from 550,000 to 1,250,000 to 1.7 million in the same period. In 1945, it was estimated that there were 800,000 traditional Chinese doctors in China and only 12,000 Western doctors.

The domestic Chinese medicine market in China is valued at more than $1 billion. Chinese medicine is protected by the Chinese constitution and is covered by national insurance. It is generally cheaper than Western medicine and tends to be relied on more in the countryside among older people in part because of the lower cost.

In China, there is a growing interest in traditional medicine among sophisticated urban people as celebrities promote their favorite cures and a number of books, DVDs and website are available. Lectures are organized by companies, health clubs and community centers. Popular dramas such as The Great Royal Doctor, about an Imperial era bonesetter, attract large audiences and bring attention on traditional institutions like the 200-year-old Pingle Style Bone-Setting School.

Ton Ren Tang, a 360-year-old apothecary that once served China’s emperors, is now a major Chinese medicine chain with over 1,000 outlets.

Websites and Resources

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More tongue analysis
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acupunctureproducts.com
Good Websites and Sources on Traditional Chinese Medicine (TCM): National Center for Complimentary and Alternative Medicine on Traditional Chinese Medicine (TCM) /nccam.nih.gov/health ; National Center for Biotechnology Information resources on Chinese Medicine ncbi.nlm.nih.gov ; Skepticism of Chinese Medicine quackwatch.org ; Origins of Chinese Medicine logoi.com History of Chinese Medicine albion.edu/history ;Americam Journal for Chinese Medicine Chinese Text Project ; Wikipedia article on Traditional Chinese Medicine Wikipedia ; Oriental Style ourorient.com Americam Journal for Chinese Medicine ejournals.worldscientific.com Animals and Chinese Medicine: Tigers in Crisis tigersincrisis.com ; Bear Bile Farms Pictures all-creatures.org ; Animals Asia. Org animalsasia.org Starfish, Scorpions, Lizards and Chinese Medicinethingsasian.com Independent article about lizards and antlers and Chinese Medicine independent.co.uk

On Acupuncture: Wikipedia article Wikipedia ; Mayo Clinic on Acupuncture mayoclinic.com ; National Institute of Health (NIH) on Acupuncture nlm.nih.gov/medlineplus/acupuncture ; Holistic Online holisticonline.com ; American Association of Acupuncture and Oriental Medicineaaaomonline.org ; Acupuncture Treatment.com acupuncture-treatment.com On Qi Gong Literati Traditionliterati-tradition.com ; Wikipedia article Wikipedia ; Classical text sources neigong.net ; Qi Gong Institute qigonginstitute.org ; Qi Gong association of America /www.qi.org ; Skeptic’s Dictionary on Qi Gong skepdic.com More Skepticism of Qi Gong quackwatch.org On Moxibustion : Acupuncture Treatment.com acupuncture-treatment.com ; Moxibustion Video YouTube ; Wikipedia article on Fire Cupping Wikipedia ; Article on Cupping itmonline.org ; Cupping Video YouTube

Links in this Website: HEALTH IN CHINA Factsanddetails.com/China ; HEALTH CARE IN CHINA---DOCTORS, INSURANCE AND COSTS Factsanddetails.com/China ; HEALTH CARE IN CHINA--- TRANSPLANTS AND DRUGS Factsanddetails.com/China ; TRADITIONAL CHINESE MEDICINE Factsanddetails.com/China ; ACUPUNCTURE Factsanddetails.com/China ; QI GONG AND MOXIBUSTION Factsanddetails.com/China ; ANIMAL PARTS AND CHINESE MEDICINE Factsanddetails.com/China ; DISEASES IN CHINA Factsanddetails.com/China ; AIDS-HIV IN CHINA Factsanddetails.com/China ; SARS IN CHINA Factsanddetails.com/China ; INFLUENZA AND A/H1N1 FLU IN CHINA Factsanddetails.com/China ; BIRD FLU IN CHINA Factsanddetails.com/China

Philosophy Behind Chinese Medicine

Chinese medicine emphasizes prevention rather than cure and views the cause of illness as a weak level of energy, which can be treated with a strength-giving restorative medicine. It focuses on "promoting wellness" and treating diseases by locating disharmonies and imbalances and restoring harmony and balance. Agents that cause disease are regarded as belonging to the same universe as the body and treatment is not a mater of killing or getting rid of them but in restoring their balanced place in the universe.

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Ma Kou carrying medicinal plants
Practitioners of Chinese medicine believe that health is regulated by a rhythm of yin (the passive female force) and yang (the active male force), which in turn are influenced by the "five elements" (fire, water, tree, metal and soil), the “six pathogenic factors,”(cold, wind, dryness, heat, dampness and fire) and the “seven emotions” (joy, anger, anxiety, obsession, sadness, horror and fear). In healthy people these forces are in harmony. In unhealthy ones they are out of balance. Too much or too little food, drink, work or exercise can also throw the whole system out of wack. Many Chinese believe that hip problems can be caused by excessive drinking and hormone imbalances.

Disease is believed to be caused when a patient’s qi (pronounced "chee") is too weak, out of balance or blocked. Qi is a "vital force" present thought out the universe that makes life possible. Qi flows through the body along 14 major channels, or “meridians.” The task of a Chinese doctor is make the qi strong by restoring its balance with the universe and harmonizing the internal rhythms of the patient with the rhythms of his or her environment. Medical problems are approached holistically. Knowledge of internal anatomy is not necessary because the body gives external clues for imbalances on the inside.

Explaining why he takes Chinese medicine one policeman in Beijing told the New York Times, “It is a part of the Chinese tradition to drink these medicines, and at the very least it gives you peace of mind.”

History of Chinese Medicine

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Bonchogangmok
According to legend the mythical emperors Huang-di and Shen Nung founded the two main forms of Chinese medicine---acupuncture and pharmacopeia---in 2,700 B.C. through their interaction with extraordinary creatures such as dragons and turtles. Emperor Qin devoted a lot of time, energy and resources searching for an elixir of immortality in the 3rd century B.C.

Many of the basic principals of Chinese medicine were laid down more than 2,000 years ago in the Yellow Emperor’s Classic of Internal Medicine. The 7th century physician Sun Dsu-miao is regarded as the Hippocrates of China. He asserted that doctors should treat poor patients just as well as the rich. The medical guide New and More Detailed Pharmacopoeia of Khai-Pao reign-Period was widely in use in A.D. 1000.

Marco Polo wrote of rhubarb being used in China as a laxative in the 11th century. Eye drops made from the mahuang plant, which contains ephedrine hydrochloride, were used in China in 3000 B.C. Ephedrine hydrochloride is still used to treat minor eye irritations today.

Many Chinese medicine prescriptions come from the Bonchogangmok, a 16th century book on medicinal herbs. A dispensary used by the Qing emperors is patronized by customers in Beijing who use the same medicines as emperors mixed according secret formulas.

"Barefoot doctors," who were first sent out into the countryside by Mao Tse-tung after the revolution, used one of the China’s most successful herbal medicines---pumpkin seeds---to rid patients of worms. Today the treatment is also used in Africa to combat snail fever, or schistosomiasis.

Examination by a Chinese Medicine Doctor

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Treatment by Chinese medicine doctor
A Chinese medicine doctor diagnoses a patient by looking into his face, eyes, tongue, ears and nose and by listening to the voice and feeling the pulse and skin. Treatment usually involves acupuncture, qi gong, meditation, dietary changes and herbal remedies.

Some doctors look at the face for negative differences in the teeth, hair and ears. The nose is examined for problems with the lungs. Heart problems are diagnosed with the tongue. Liver problems are checked by examining the color of the skin. Some doctors carefully check the iris of the eye. Smell is also important in Chinese medicine, One doctor said, "For example, the smell of a patient who has cancer is different from the one who has had stroke."

After an examination a Chinese doctor might declare that a patient’s insomnia is caused by an “energy leak” from the heart. As one doctor explained to Newsweek, “The heart governs the mind. You have too many thoughts. You can’t get them out of your brain when you sleep.” Peptic ulcers are said to be caused by “deficient yin of the stomach” or “damp heart affecting the spleen” or “disharmony of the liver invading the spleen.”

According to the Discussion on Cold-Induced Disorders by Jan Jung Gyung, written in the Han Dynasty (206 B.C. to A.D. 220), colds are caused by the invasion of Outer Coldness on the body, a process that occurs in six stages. The first stage of a cold, known as tae-yang, is characterized by stiffness of the head and neck, shivers, and a "floating pulse." The second state, yang-myung, occurs when the Outer Coldness infiltrates the area governed by the Stomach Vessel. Symptoms include a dry throat and dizziness near the eyes. Treatment, which is still followed today is based on halting the symptoms at each stage, preventing the next one from occurring.

Chinese Doctor and the Pulse

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Pulse taking
Chinese medicine doctors examine their patients pulses and tongues as Western doctors do but what they usually find is different than what Western doctors find. Chinese medicine doctors have identified more than 30 different kinds of pulses, including slippery, full, floating, rapid, slow, thready, empty, leisurely, irregular and regularly irregular. Tongues can be diagnosed as slippery, dry, pale, greasy, having a thick coating or having no coating at all.

There are 12 different pulses for each of 12 identified major organs. Describing his own treatment, journalist Rick Weiss wrote in the Washington Post, "Ming carried no stethoscope, ordered no tests and didn't tap my knees with a chrome-plated hammer. Instead, he looked at my tongue. Then squeezed my fingernails. Then he felt my pulse at each wrist, sensing not just the rush of blood in my arteries but the subtle pulsing of 12 different signals, unrecognized by modern science, that in Chinese medicine are said to provide information about all the various organ systems in the body."

A critic of Chinese medicine Professor Zhang Gongyao told the Times of London, “What exactly is the pulse” Do they hear the flow of blood, or is it the heartbeat, the breath and the softness of the blood vessels? Some doctors boast they can even tell a woman is pregnant from here pulse. The biggest problem is there is no standard.”

Modern Chinese Medicine

Oriental doctors in Asia are licensed by the government. Universities have acupuncture departments. Doctors and pharmacists practicing Chinese medicine have to attend medical school and pass exams just like doctors who practice Western medicine.

A typical conference on Oriental medicine is attended by over 2,000 doctors from 30 countries. Lectures are given by doctors from China, Japan, South Korea and Taiwan on topics like "The Treatment of Cardiovascular Disease with Traditional Chinese Medicine," "Patho-physiological Analysis of Blood Stagnant Syndrome” and the "Evaluation of Efficacy of Bronchial Asthma by Clinical Trials, Laboratory Tests."

Some Chinese medicines are more regarded as little more than snake oil tonics. Yet others are remedies that have been used successfully in Chinese hospitals and clinics for hundreds of years to treat a number of maladies.

Only recently have Western doctors begun to study Asian medicines with carefully controlled studies. In September 2002, 1,500 researchers from 28 countries presented more than 1,000 research on traditional Chinese treatments, most of them using Western research methods. The research found that Chinese medicine is most effective treating chromic ailments such as digestive disorders, recurring migraines, menopausal symptoms. in which Western medicine is the most ineffective. The study of Chinese medicines is difficult because remedies are often blends of several herbs.

See Acupuncture Below

Chinese Medicine versus Western Medicine

Western medicine was introduced to China in the 16th century by missionaries but for centuries was merely a curiosity. In the 19th century missionary hospitals became more widespread as Europeans increased their presence in China. Many Chinese refused to use them in part because of rumors that were spread about Western doctors harvesting organs from patients and storing them in churches and using children’s hearts in black magic rituals. Western medicine won some respect in 1894 during an outbreak of the bubonic plague, a disease that Chinese herbal medicine was powerless in combating.

“The extent to which traditional and Western treatment methods were combined and integrated in the major hospitals varied greatly. Some hospitals and medical schools of purely traditional medicine were established. In most urban hospitals, the pattern seemed to be to establish separate departments for traditional and Western treatment. In the county hospitals, however, traditional medicine received greater emphasis. [Ibid]

On its down side, Huh Jong, a professor at Seoul National University, wrote: "Western medicine is designed to fight diseases which have already invaded the body and to use string medication to eliminate the harmful microorganisms. However, the side effects of strong treatments can result in further deterioration to the patient’s well-being and viruses often grow immune to intensifying medication.”

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Chinese medicine shop

Dr. Haruki Yamada of the Oriental Medicine Center of the Kitasato Institute in Tokyo said, "Western medicine is very important and efficient for the treatment of many diseases but it is not perfect. Oriental medicine can cure diseases that cannot be covered by Western medicine. Using both types can be very useful depending on the disease." The World Health Organization is currently researching Asia medical system.

Many doctors in Asia try to use the "three roads" approach to medicine: Western medicine, Oriental medicine and a combination of the two. If a Chinese man or woman becomes ill often he or she will seek out a doctor who practices Western medicine and one who practices Chinese medicine. According to one doctor, "traditional Chinese therapies are applied for better treatment and recuperation results." Still there is little evidence that Chinese medicines can be used to cure serious diseases like cancer and heart disease.

Some hospitals, like 304 Military hospital in Beijing, have an east wing for Chinese medicine and a west wing for Western medicine. People with chronic ailments like arthritis and back pain are directed to the east wing. Those with acute problems like a heart attack or a broken leg told to go to the west wing.

Oriental medicines are becoming increasingly popular in the West. A third of all adult American males have seen a doctor who practices oriental medicine. Oriental medical doctors have been sent to Ethiopia, Gabon and Kazakstan to help ailing poor people.

Chinese Medicine versus Western Medicine in China

Although the practice of traditional Chinese medicine was strongly promoted by the Chinese leadership and remained a major component of health care, Western medicine was gaining increasing acceptance in the 1970s and 1980s. For example, the number of physicians and pharmacists trained in Western medicine reportedly increased by 225,000 from 1976 to 1981, and the number of physicians' assistants trained in Western medicine increased by about 50,000. In 1981 there were reportedly 516,000 senior physicians trained in Western medicine and 290,000 senior physicians trained in traditional Chinese medicine. The goal of China's medical professionals is to synthesize the best elements of traditional and Western approaches. [Source: Library of Congress]

“In practice, however, this combination has not always worked smoothly. In many respects, physicians trained in traditional medicine and those trained in Western medicine constitute separate groups with different interests. For instance, physicians trained in Western medicine have been somewhat reluctant to accept "unscientific" traditional practices, and traditional practitioners have sought to preserve authority in their own sphere. Although Chinese medical schools that provided training in Western medicine also provided some instruction in traditional medicine, relatively few physicians were regarded as competent in both areas in the mid- 1980s. [Ibid]

Critical Studies of Chinese Medicine

These days critics of Chinese medicine within are becoming more and more vocal. Some claim that the medicines are ineffective and dangerous because they are sometimes used in lieu of Western medicines that are effective and sometimes contain toxic substance. Some have compared Chinese medicine to witchcraft, with practitioners killed at offering excuses why it doesn’t work. . Other want to Chinese medicine stripped of its protected status by the Chinese constitution, require pratcitioners of traditional medicine ro receive Western training and traditional cures undergo thorough Western-style testing.

As a rule alternative medicines---including Chinese medicines---have not been studied as carefully or put through the same kind of scrutiny as modern medicines. Those that have been studied have often been done so with dodgy science---namely small sample sizes and lack of control groups.

In the United States, the National Center for Complementary and Alternative Medicine (NCCAM) has a $122 million budget to study alterative medicine with rigorous methodology in cooperation with the National Institute of Health (NIH). The trials are longer and larger and if one treatment shows promise it is studied more carefully, which is the usual pattern with modern medicine.

Many criticize the efforts as waste of money and giving legitimacy to quack medicines.Steven Novella at Yale Medical School told the Washington Post, “What has happened is that the very fact that NIH is supporting a study is used to market alternative medicine. It is used to lend an appearance of legitimacy to treatments that not legitimate.”

In the United States and Japan several Chinese medicines and herbal cures have been banned after being linked to several deaths, In the United States ephedra was banned after it was linked to heart attacks and strokes. See Japan. Some treatment contain heavy metals, other arsenic and mercury Practitioners of Chinese medicine have said the problem was on eh dosage and incorrect application not o je drug itself.

One of the chief critics in China is Professor Zhang Gongyao. He said, “Traditional Chinese medicine has no clear understanding of the human body, of the functions of medicines and their links to disease. It’s like a boat without a compass: it may reach the shore, but it’s all up to luck.”

Herbal Remedy Blamed for High Cancer Rate in Taiwan

In April 2012, AFP reported: “A toxic ingredient in a popular herbal remedy is linked to more than half of all cases of urinary tract cancer in Taiwan where use of traditional medicine is widespread, a US study said. Aristolochic acid (AA) is a potent human carcinogen that is found naturally in Aristolochia plants, an ingredient common in botanical Asian remedies for aiding weight loss, easing joint pain and improving stomach ailments. [Source: AFP, April 11, 2012]

“The ancient herb has been touted around the world for thousands of years for everything from gout to childbirth, but scientists now know it carries serious risks of causing kidney disease and urinary cancers. The latest research found it can interact with a person's DNA and form unique biomarkers of exposure, as well as creating signals within tumor suppressing genes that indicate the carcinogen has been ingested. [Ibid]

“In Taiwan, where previous research has shown about one-third of the population has taken AA in recent years, rates of urinary tract and kidney cancer are about four times higher than in Western countries where use is less common, said the findings in the Proceedings of the National Academy of Sciences. "It is a rare tumor and Taiwan has the highest incidence of any country in the world," said lead author Arthur Grollman of the department of pharmacological sciences at Stony Brook University in New York. "The fact that Taiwan had the highest incidence both of cancer and this renal disease -- that was our clue that something was going on there," Grollman told AFP. [Ibid]

“The research was based on 151 patients with urinary tract cancer, of whom 60 percent showed specific mutations linked to the herbal remedy. In particular, after being ingested the acid forms a unique kind of lesion in the renal cortex, and also gives rise to a particular mutational signature in the TP53 tumor suppressing gene, said the study. [Ibid]

“The herb is known in Europe by the name birthwort because it was often given to women during childbirth. Derived from the Greek, "aristolochia" means noble birth. "This has been used by every culture in the world from the earliest written record," said Grollman.Signs of harm have emerged in recent decades, and the acid is blamed for causing a kidney disease called Balkan endemic nephropathy, first described in 1956, that afflicted rural farmers in Bosnia and Herzegovina, Bulgaria, Croatia, Romania and Serbia. The villagers were found to be baking seeds from a weed called Aristolochia clematitis in their bread. In the 1990s, a group of Belgian women reported sudden late stage kidney failure after taking a weight loss drug that contained AA. [Ibid]

“And even though many countries have taken steps to warn of the risks, the ingredient is difficult to control and still finds its way into products via the Internet, said Grollman, adding that most of the AA products currently being used in Taiwan are made in China."Many countries ban it but it is always available on the Internet. And in fact you can't ban it in the United States. You can only ban its importation." The US Food and Drug Administration warned of the risks of aristolochic acid in 2001 after two patients developed serious kidney disease after using botanical products containing it. "Natural is not necessarily safe, nor is long-term usage," said Grollman. [Ibid]

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DNA Tests Point Out Dangers with Traditional Chinese Medicine

In April 2012, AFP reported: “A host of potential toxins, allergens and traces of endangered animals showed up in DNA sequencing tests on 15 Chinese traditional medicines, researchers said. Despite their popularity, little scientific evidence exists to prove the benefits of Chinese traditional medicines (TCMs), and a growing body of research has begun to point to their potential dangers. [Source: AFP, April 13, 2012]

“The samples analysed for this study included herbal teas, capsules, powders and flakes that were seized by Australian border officials and were subsequently tested by scientists at Australia's Murdoch University. Plant agents suspected of causing urinary tract and kidney cancer such as Aristolochic acid, as well as the potentially poisonous herb ephedra were among the dangerous elements found. [Ibid]

“TCMs have a long cultural history, but today consumers need to be aware of the legal and health safety issues before adopting them as a treatment option," said lead researcher Michael Bunce, a Murdoch University Australian Research Council Future Fellow. Some of the 68 different plant families that were detected in the 15 samples can be toxic if taken in the wrong doses, but the packaging did not list the concentrations of the elements inside, he said. [Ibid]

“We also found traces from trade restricted animals that are classified as vulnerable, endangered, or critically endangered, including the Asiatic black bear and Saiga antelope" he said, adding that some contained ingredients that were not included on the label. "A product labelled as 100 per cent Saiga antelope contained considerable quantities of goat and sheep DNA," he said. "Another product, Mongnan Tianbao pills, contained deer and cow DNA, the latter of which may violate some religious or cultural strictures.” [Ibid]

“Performing any in-depth analysis of the biological elements contained in traditional therapies has been difficult in the past because the act of processing ingredients into powders and pills mingled the components too much. But the approach used by researchers for this study, described as second-generation, high throughput sequencing, was both efficient and cost-effective, said researcher Megan Coghlan. "The approach has the ability to unravel complex mixtures of plant and animal products," she said. "We found multiple samples that contained DNA from animals listed as trade-restricted according to the Convention on International Trade in Endangered Species Legislation. Put simply, these TCMs are not legal." Future tests could help customs officials track the illegal trade of endangered species as well as clamp down on dangerous ingredients, she added. [Ibid]

Image Sources: Tqnyc; All Posters com http://www.allposters.com/?lang=1 Search Chinese Art ; Wikipedia; Compassionate Dragon Healing; Accupuncture Products; Iron Palm Arts; WWF; Ciao Su Nature Products; South Aquaculture

Text Sources: New York Times, Washington Post, Los Angeles Times, Times of London, National Geographic, The New Yorker, Time, Newsweek, Reuters, AP, Lonely Planet Guides, Compton’s Encyclopedia and various books and other publications.

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© 2008 Jeffrey Hays

Last updated July 2012

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