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The ‘sense and nonsense’ (and big business) of traditional Chinese medicine

James Palmer exposes this approach to healing for what it is: a “beautiful and intricate” but unscientific and thus potentially dangerous set of medical theories and practices.

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Chinese authorities have allowed traditional medicine to flourish side-by-side with modern “Western” medicine.

The British digital magazine Aeon has published a long and fascinating article by Beijing-based journalist James Palmer (“The Death of Mao”) on “the odd, dangerous mix of sense and nonsense” that is traditional Chinese medicine.

In the article, Palmer pulls back the curtain on this often romanticized approach to treating illness, and exposes it for what it is: a “beautiful and intricate” but unscientific and thus potentially dangerous set of medical theories and practices. But even more interesting is his description of the history of how and why Chinese authorities have allowed traditional medicine to flourish side-by-side with modern “Western” medicine.

As Palmer notes (with British spellings), “The institutionalization of traditional Chinese medicine (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.”

It’s also big business. “In modern China,” writes Palmer, “traditional Chinese medicine (TCM) is not the realm of private enthusiasts, spiritual advisers or folk healers. It’s been institutionalized, 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.”

A pushback against skeptics

Here are some other excerpts and insights from the article:

  • “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.”
  • Chinese scientists and physicians who publicly challenge the role of TCM in modern medical practice often pay a high professional price for their opposition. One outspoken TCM skeptic, a professor of medical history, circulated an unsuccessful petition to remove TCM from government-run medical institutions — and was promptly accused by officials and others of being “ignorant.”  “Since then,” the professor told Palmer, “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.”
  • “TCM’s claims of being ‘natural’ are also highly appealing in [a] country where everything from dumpings 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!’”
  • “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.”
  • “Around 30 to 35 percent of TCM drugs, according to UK and US studies, contain conventional medicines. … 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.”

A distrust of conventional medicine

Much of the appeal of TCM to the Chinese, explains Palmer, is due to their often-justified distrust of conventional doctors:

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The Chinese public … 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 percent of ‘doctors’ in Chinese hospitals have an MD, another 20 to 25 percent have MAs, leaving the vast majority with only bachelor’s degress 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. …

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.

But, as Palmer points out, TCM can also be expensive and dangerous. “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,” he writes. “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 percent of China’s TCM products are blocked from export, according to the World Federation of Chinese Medicine Societies, a government-approved industry group.”

Palmer’s article is a definite must-read for anybody who maintains a rose-colored vision of traditional Chinese medicine. You’ll find it online on the Aeon Magazine website.