Traditional Chinese medicine

Traditional Chinese medicine (or TCM) refers to the theories and practices of diagnosis and healing developed historically in China. Beginning in ancient times, its influence spread to neighbouring countries such as Korea and Japan, and largely shaped their traditional medicine. More recently, TCM has become popular as an alternative medicine in Europe and North America.
Like much Chinese lore, such as feng shui and the martial arts, Chinese medicine is based on the qi (or chi, 氣) principle of energy. Qi is said to be channelled through a complex system of meridians in the body, and illnesses are believed to be related to blocked or unbalanced flow of qi.Chinese Traditional Medicine: An Alternative and Complementary Medicine Resource Guide Alternative Medicine Foundation Common treatments include acupressure, acupuncture, acupuncture bloodletting, reflexology, and herbal medicine, though treatments can also be of inorganic, animal or even mythologic origin (clawed human, one-footed monster, sprite/elf/naiad, and dryad).Chinese Materia Medica: Animal Drugs by Bernard E. Read (1931). Peking Natural History Bulletin. Based upon the "Pen Ts'ao Kang Mu" [Bencao Gangmu] by Li Shih-Chen [Li Shizhen]. In one study, 260 TCM products sold in California were analyzed for adulterants: 32% contained drugs and/or heavy metals.A U.S. Perspective on the Adverse Reactions from Traditional Chinese Medicines by Richard J. Ko (2004) J. Chin. Med. Assoc. 67:109-116.
==History==
===Alleged mythical origins===
Fuxi (or Paoxi, 伏羲) was a legendary ruler to whom many fundamental aspects of domestic life (animal domestication, cooking, etc.) have been ascribed, including medical philosophy and the I Ching.History of Chinese Medicine: Being a Chronicle of Medical Happenings in China from Ancient Times to the Present Period by K. Chimin Wong & Wu Lien-Teh (1936) National Quarantine Service. One of the who is variously considered as deity or a god-emperors is considered by the Chinese to be the founder of Chinese medicine: Shennong (神農 or 神农) is claimed to have discovered herbalism and to have written the first treatise on herbs, the (神農本草經). In addition, he was said to have discovered, or invented, tea, the hoe, the plow, the axe, wells, irrigation, preserving seeds in boiled horse urine, the 24 hours of the day, the calendar, the weekly farmers' market, the harvest festival, pulse measuring, moxibustion and acupuncture.Handbook of Chinese Mythology by Lihui Yang & Deming An (2008) Oxford University Press. ISBN 0195332636. Additionally, he was said to have known the secret to immortality and the transmutation of substances into gold.
Religion was deeply intertwined with Chinese medicine, particularly in the earliest years, and it included sorcery, divination (I Ching), astrology In ancient times, doctors were referred to as priest-doctors (Wu I). Spirituality remains an important part of Chinese medicineSpirituality in Traditional Chinese Medicine by Lin Shi & Chenguang Zhang (2012) Pastoral Psychology 61(5–6):959–974. doi.org:10.1007/s11089-012-0480-x.
The Chinese have a reverence for authority, in large part due to the "Five Relationships" of Confucianism. This likely is a source of resistance to change and acceptance of evidence-based medicine.
===Pre-modern history===
Chinese medicine is based upon four ancient, mutually-contradictory classics:Chinese Medicine in Early Communist China, 1945-1963: A Medicine of Revolution by Kim Taylor (2005). Routledge. ISBN 041534512X.
# (黃帝內經) or Inner Canon of the Yellow Emperor or Inner Canon (c. 100 CE)
# (傷寒論) or Treatise on Cold Damage Diseases or Book of Cold Damage (c. 200 CE)
# (金匱要略) or Essential Prescriptions from the Golden Cabinet or Golden Casket (c. 200 CE)
#Various texts of 'warmth-factor diseases' (known as wenbing, 温病) (17th-19th centuries CE)
===Proto- and Pseudo-Science===
While today, what has worked in the 'fields' of herbalism has been added to pharmacology and what hasn't worked has been discarded, prior to the scientific method, there really wasn't a good way to gather reliable information. Various medicine men and priests and the like would have made an observation and passed it on to other healers, but not have the resources or education to actually test these observations. Some of the herbs and such would work (for example, willow bark tea), others did not. But without the resources of a modern university research department, better forms of acquiring knowledge weren't really practical. Various herbal and folk remedies that relied on limited observation and lacked rigorous testing were protosciences rather than pseudo-sciences. That is, "not yet sciences", rather than "never sciences".
There were indeed some important discoveries made by Chinese medicine. The most important of which was "variolation" (vaccination); exposing someone to a weak form of smallpox (or cowpox) to prevent that person succumbing later on to a deadlier form of smallpox. This folk remedy happened to work, and spread to India, then to the Ottoman Empire and then to Europe. This makes vaccine denialists that adhere to other forms of TCM a rather strange breed.
===Modern times===
thumb|right|250px|What? It's just an ordinary ginseng liquo-OH MY GOODNESS!
====In China====
Access to Western medicine in China was especially difficult in China up through the first half of the 20th century due to poverty and wars (particularly the Second Sino-Japanese War and the Chinese civil war). During the Chinese Civil War, the People's Liberation Army used Chinese medicine by necessity for lack of reliable access to anything else. Following the victory of the People's Liberation Army, Mao Zedong saw the importance of maintaining the employment of the hundreds of thousands of people involved in various aspects of Chinese medicine, so as to assure social stability. Mao laid out abstract goals (or slogans) for the integration of Chinese and Western medicine, the details of which were left to Chinese Communist Party officials:
*1945-50: The Co-operation of Chinese and Western Medicines
*1950-58: The Unification of Chinese and Western Medicines
*1950-53: Chinese Medicine Studies Western Medicine
*1954-58: Western Medicine Studies Chinese Medicine
*1958-: The Integration of Chinese and Western Medicine
Evidence suggests that as early as 1954, Mao had doubts about the effectiveness of Chinese medicine. Both Mao and Li Zhisui, Mao's personal physician, were very skeptical of the usefulness of Chinese medicine.The Private Life of Chairman Mao by Li Zhisui (1996) Random House. ISBN 0679764437. Mao was also ignorant of modern medicine. Because Mao was privately skeptical of Chinese medicine and ignorant of modern medicine, his promotion of integrative medicine was entirely a political maneuver, meaning that his strong and continuous promotion of Chinese medicine was intentionally promoting nationalism while sacrificing the physical health of the nation. The nationalist aspect Chinese medicine was made explicit by:
#Mao's use of the slogan, "China's medicine and pharmacology is a great treasure-house!!" (中国药学是一个伟大的宝库!! zhongguo yiyaoxue shi yige weida de baoku)
# a Western medicine trained physician in the revolutionary army who eventually became director of the People's Government Ministry of Health, endorsed the idea of nationalist-based sciences. He Cheng was particularly interested in Soviet science.
The problem with relying on nationalist science is that there is no such thing. Science is based on a universal, the scientific method. Soviet science, while excellent in some regards, was deficient in others due to reliance on ideology and dialectical materialism.Soviet Science Guided History: History Research Guides by Boston University Students. Soviet biology under Stalin was even worse, as he actively persecuted evolutionary science in favor of Lysenkoist bullshit, because it told him what he wanted to hear, not what would actually work.
It was during this period (roughly mid-1950s to mid-1960s) that Chinese medicine became standardized, resolving or glossing over the contradictory elements of the four ancient texts. In 1955, the term 'Traditional Chinese Medicine' (in capital letters) began to be used to refer to this standardized version to the English-speaking world; notably, it was first used as a political term. The term in Chinese however remained the same as it was in pre-revolutionary China, 中医 (zhongyi) as it always had, which just translates to 'Chinese medicine', a term that was used starting in the 19th century to contrast it with Western medicine (西医, xiyi). It was also during this period that the idea of integrated medicine developed, based on Mao's sloganeering, the mixing Chinese and Western medicine. Other non-standardized forms of Chinese medicine are still practiced both within the People's Republic of China (PRC) and in Singapore, Hong Kong and Taiwan.
Despite the death of Mao, the rise of capitalism, the general lack of evidence supporting TCM, and the preference of Chinese citizens for TCM only for minor ailments, the Chinese government continues to actively promote TCM within China and abroad,China adopts law on traditional medicine Xinhua (December 26, 2016).In the tradition of Chairman Mao, traditional Chinese medicine gets a new boost by the Chinese government. Despite a lack of evidence for its efficacy and safety, traditional Chinese medicine (TCM) has made major inroads into US medical centers, both academic and community. I’ve told the story of how Chairman Mao Zedong created the myth of TCM and promoted it to credulous Westerners to facilitate the "integration" of TCM and "Western medicine." Over the holiday break, I learned that this process continues apace, even in today’s China. by David Gorski (January 2, 2017) Science-Based Medicine. likely based on a sense of nationalism.
====In the West====
TCM became more widely noticed in the West beginning in the 1970s.Traditional Medicine in Modern China: Science, Nationalism, and the Tensions of Cultural Change' by Ralph C. Croizier (1968) Harvard University Press. The biggest publicity generator for China at this time was acupuncture analgesia for surgery, which was publicized by James Reston, a New York Times reporter who accompanied Secretary of State Henry Kissinger to China in 1971, in preparation for President Richard Nixon's visit in 1972. Reston had an emergency appendectomy while in China using conventioanal anesthesia, and received post-surgical acupuncture analgesia, which he described as causing diversionary pain.Now, About My Operation in Peking by James Reston (July 26, 1971) The New York Times. Pages 1 and 6. The acupuncture "sent ripples of pain racing through my limbs and, at least, had the effect of diverting my attention from the distress in my stomach." Acupuncture analgesia has been portrayed elsewhere as occurring during surgery, but this has largely been debunked: when acupuncture has been used during surgery, it has been used in addition to chemical sedatives.Acupuncture Is Theatrical Placebo by David Colquhoun & Steven Novella (2013) Anesthesia & Analgesia 116(6):1360-1363.Acupuncture Doesn't Work by Steven Novella (June 19, 2013) Science-Based Medicine."Acupuncture Anesthesia": A Proclamation from Chairman Mao: Part I, Part II, Part III, and [Part IV by Kimball Atwood (May 15, 2009 - June 26, 2009) Science-Based Medicine.'Acupuncture Anesthesia' Redux: another Skeptic and an Unfortunate Misportrayal at the NCCAM by Kimball Atwood (July 24, 2009) Science-Based Medicine.
Notably, the first three Western textbooks on TCM following Reston's articleTheoretical Foundations of Chinese Medicine: Systems of Correspondence by Manfred Porkert (1978) The MIT Press. ISBN 0262660407.Web That Has No Weaver: Understanding Chinese Medicine by Ted Kaptchuk (1983) Congdon & Weed. ISBN 0865531099.Traditional Medicine in Contemporary China: A Partial Translation of "Revised outline of Chinese medicine by Nathan Sivin (1987) IAnn Arbor Center for Chinese Studies. ISBN 0892640731. were based on a 1958 PRC textbook, The Outline of TCM (中医学概论, Zhongyixue Gailun)中医学概论 (Zhongyixue Gailun) by Jingchun Meng (1958) 人民衛生出版社. that was filtered through revolutionary communist fervor.
TCM has become popular in North America and Europe during recent decades, largely due to the growing popularity of CAM (Complementary and Alternative Medicine) and the New Age preoccupation with other Eastern woo such as feng shui, Chinese astrology, Reiki and Zen Buddhism. As with most of these fads, the most common variants of TCM popularised in the west tend to be simplified and bastardised versions of authentic TCM, and are often bundled with other forms of CAM. For example, Chinese medicine centers in the UK and USA often offer non-Chinese complementary therapies such as hypnotherapy and homeopathy, alongside Chinese herbalism and acupuncture.
However, just because one remedy works does not mean all the others work. Each remedy or herb gets tested; those that work become part of medicine, while those that don't get discarded. Keeping the remedies that are unproven or have been proven not to work is instead pseudoscience.
==Materia medica==
The (本草綱目) or Compendium of Materia Medica was first published in the 1578 by (李時珍). An early book was written in 1505 by the physician Liu Wentai under orders from Emperor Xiaozong, titled Bencao Pinhui Jingyao (Collection of the Essential Medical Herbs of Materia Medica), but this book was not available to the general public and is not now well-known.Collection of the Essential Medical Herbs of Materia MedicaA Brief History of Chinese Medicine and Its Influence by Peng Yoke Ho & F. P. Lisowski (1999). World Scientific, 2nd ed. ISBN 9810228031.
The Bencao Gangmu has remained in use continuously since its publication, and was replaced in China by the 10-volume Zhong Hua Ben Cao (中华本草, Encyclopedia of Chinese Materia Medica) in 1999.Health Department and National Chinese Medicine Management Office (ed.). Zhong Hua Ben Cao, 3–460–509. Shanghai Science Technology Publication. 1999. ISBN 7532351068. The now-official Pharmacopoeia of the People's Republic of China was published in 2005.Pharmacopoeia of the People's Republic of China (2005). Chemical Industry Press, 2 volumes: ISBN 7502520627 and ISBN 7502520635.
===Controversial and dangerous ingredients used in TCM===
TCM ingredients can range from common plants, such as dandelion, persimmon, and mint, to weird or even dangerous stuff. Some things found in TCM include genitals of various animals (including dogs, tigers, seals, oxen, goats, and deer), bear bile (commonly obtained by means of slow, inhumane extraction methods), and (genuine) snake oil.Freeing China's caged bile bears / Animal activists aim to curtail trade in traditional remedy, SFgate.Media Releases for 2003, Medsafe. It is worth noting that the sale and use of all of these animal ingredients is illegal in many parts of Asia, Europe, North America and almost everywhere else. New methods of combating the use of these illegal animal parts have been discussed.Combatting the illegal use of endangered animals in traditional medicine (November 6, 2013) Natural Reactions. Urine, feces, placenta and other human-derived medicines were traditionally used but some may no longer be in use."The Treatment of 75 Cases of Pediatric Oral Thrush with the Sweet, Cold, Protecting Yin Method" by Wang Le-ping, Shang Hai Zhong Yi Yao Za Zhi (The Shanghai Journal of Chinese Medicine & Medicinals), #5, 1994, p. 22
Some of the dangerous ingredients include lead,Mi Tuo Seng — 密陀僧 — Lithargyrum American Dragon. calomel (mercurous chloride), cinnabar (red mercuric sulfide),Cinnabar Acupuncture Today. asbestos (including asbestiform actinolite,Actinolite, TCMwiki.com. sometimes erroneously called aconiteAconite Ask Dr. Mao) realgar (arsenic),Realgar (xiong huang) Acupuncture Today. and birthwort (Aristolochia spp.). Guang Fang Zi (Aristolochia Root, Stephania) — Chinese Herbal Medicine Yin Yang House. Bloodletting is also practiced. Bizarrely, lead oxide, cinnabar, and calomel are said to be good for detoxification.Cinnabar (zhu sha), TCMtreatment.com.Qian Dan, TCMAssistant.Galena, Acupuncture Today.Mercury and Chinese herbal medicine by H.C. George Wong (2004) BCMJ 46(9):442.Mercury in Traditional Medicines: Is Cinnabar Toxicologically Similar to Common Mercurials? by Jie Liu et al. (2008) Experimental Biology and Medicine 233(7):810-817. doi:10.3181/0712-MR-336. Lead oxide is also supposed to help with ringworms, skin rashes, rosacea, eczema, sores, ulcers, and intestinal parasites, cinnabar allegedly helps you live longer, and asbestos is used (including in powder form) for treating impotence, spermatorrhea, premature ejaculation, colic, muscle cramps, prostatitis, endometritis, as well as for kidney-warming and yang-fortifying. Admittedly, the amounts of cinnabar and calomel used in TCM are small enough that the damage they cause is usually reversible.
A 1998 study of 260 imported Asian patent medicines collected in California found that 14 had labels with declared pharmaceutical ingredients.Adulterants in Asian Patent Medicines by Richard J. Ko. (1998) N. Engl. J. Med. 339:847. doi:10.1056/NEJM199809173391214. Of 243 products that were chemically analyzed, 17 had undeclared pharmaceuticals (including ephedrine, chlorpheniramine, methyltestosterone, and phenacetin). Of the 251 products that were chemically analyzed, 24 contained lead in the range of 10 to 319 ppm, 35 contained arsenic in the range of 20.4 to 114,000 ppm, and 35 contained mercury in the range of 22.4 to 5070 ppm. By way of comparison, the United States Pharmacopoeia limits heavy metals in pharmaceuticals to 30 ppm in most cases.
Sites selling or promoting TCM remedies often lump all their products or recommended treatments under the generic term "herbs". However, many of these herbal products are really of mineral or otherwise non-herbal origin. These "herbs" are sometimes listed by their Chinese or mineral names (which people don't really recognize). Instead of listing "lead", they list a "herb" called mi tuo seng or "galena"; instead of listing asbestos, they list yang qi shi, and so on.
===Lethal substitution===
TCM allows for the substitution of ingredients that have the same or similar names in Chinese.Complexities of the herbal nomenclature system in traditional Chinese medicine (TCM): lessons learned from the misuse of Aristolochia-related species and the importance of the pharmaceutical name during botanical drug product development by K. M. Wu et al. Phytomedicine. 2007 Apr;14(4):273-9. Epub 2006 Jul 24. In Belgium, a weight-loss spa using TCM herbs gave its clients herbal supplements containing birthwort, and as a result, more than 100 out of 1800 of its patients developed kidney failure, and several also developed urothelial and kidney cancers. In this case, the relatively safe Stephania tetrandra (漢防己, Han Fang Ji) was intended for the clients, but the lethal Aristolochia fangchi (廣防己, Guang Fang Ji) was given to them instead.Aristolochic acid nephropathy: A worldwide problem by Debelle et al. Kidney International (2008) 74, 158–169; doi:10.1038/ki.2008.129.
===Environmental impact===
In TCM, endangered species such as rhinos, pangolins, sharks, seahorses, manta rays, lions, leopards and tigers are highly prized; rhino horns are considered panaceas which can cure everything from arthritis to cancer, even though studies have shown they do nothing.World Rhino Day — 22nd September 2012 by Michael Evans (22 Sep 2012 0:1:0 GMT) The Earth Times.How a myth is killing the rhino by Atul Sethi (Mar 4, 2013) The Times of India.Alternative Medicine Threatens Beasts with Extinction by Benjamin Radford (August 10, 2007) LiveScience. Because of this demand, poachers hunt these animals for their body parts in order to sell them to TCM users. Since the 1970s, rhino populations have dropped 90%; while this number may not be entirely due to TCM, it can plausibly be said that TCM is significantly contributing to the extinction of endangered species by encouraging the use of these clearly ineffective as well as illegally and unsustainably sourced substances.
===Here be dragons===
 
Some also grind up dinosaur fossils (mistakenly thought by some to be "dragon bones") to be used as medicines.Chinese Medicine: "Dragon Bones" by Sharon Cornet (February 15, 2010) SunStar Solutions.Dinosaur Fossils Part of Longtime Chinese Tonic by Kevin Holden Platt (July 13, 2007) National Geographic News (archived from July 16, 2007).Dragon's Bones and Teeth by Subhuti Dharmananda. Institute for Traditional Medicine. Given that dinosaur fossils have undergone complete mineralization, these "dragon bones" could not be any more effective than eating rocks.
Bernard Read analyzed several dragon medicines used in TCM:Chinese Materia Medica. VII. Dragons and Snakes by Bernard E. Read (1934) Peking Natural History Bulletin. pp. 8-9.
Chinese name 	English translation	Actual substance
龍骨 (long gu) 	Dragon bones 	Prehistoric animal bones, fossilized
龍齒 (long chi) 	Dragon teeth 	Prehistoric animal teeth, fossilized
龍腦 (long nao) 	Dragon brains 	Type of limestone
龍涎 (long yen) 	Dragon saliva 	
==See also==
*Chinese Herbal Medicine: Materia Medica
*Pulse diagnosis
*Traditional Korean medicine
*Imperial China
==External links==
*List of traditional Chinese medicines article in Wikipedia. Very interesting read.
*From Beijing to New York: The dark side of traditional Chinese medicine, Scienceline.
*Alternative Medicine Foundation's TCM page - A good overview with a fairly extensive list of other TCM resources.
*Rock Medicines in TCM
==Notes==
==References==
Category:Alternative medicine
Category:China
 
Category:Orientalist woo
Category:Protoscience