If you are unfamiliar with TCM I suggest starting with yesterdays post
In the interest of transparency, I think it is important to note that I am skeptical of the efficacy of many TCM treatments that have not been examined by modern medicine, but so are many Chinese doctors (my discussion with doctors about TCM). Yet TCM persists, and is gaining in popularity in the West because for some people it is working.
First I think it is important to establish that there are many effective applications of TCM herbal remedies. While adherents would describe this as “proof of the system”. Western medicine (a.k.a. Science) would point out that these herbs actually contain active ingredients that treat symptoms and illnesses exactly as predicted by the scientific understanding of the body, not because of Qi blockages or Yang imbalances. TCM also includes dozens of “cures” such as tiger penis (for infertility) and rhinoceros horn (reducing fever) have been shown by modern medicine to be completely ineffective, or simply placebo effects (more on this soon).
So how can TCM be so right and so wrong at the same time?
Lets consider for a moment the origins of TCM. Thousands of years ago people realized that certain plants and animal products were useful for treating various ailments. Through experimentation, the prescription of these treatments had predictable outcomes and a system was created.
Over time the quest for not being sick, became the quest for immortality (sometime around the Qin dynasty) and experimentation expanded to include new herbs and treatments. This process continued as China’s borders reached new regions, and traders brought new goods. TCM doctors relied on apprenticeships and their own experiences to understand the effects of these cures.
The remedies that have been proven effective (as defined by modern medicine) generally come from this lineage of trial and error over thousands of years. (great example of folk-wisdom at work in modern China)
However, TCM never accounted for the placebo effect. This allowed for the introduction of remedies that relied more on superstition and subjective results rather than objective results.
In anthropological terms we can see that most of these remedies rely on sympathetic magic. Sympathetic magic refers to ascribing properties of one item to another because of similar attributes. i.e.: A tiger is very strong, so eating it would give a man strength, or that walnuts look like a brain, so they must help brain function. These treatments appeared to work, and so they were slowly incorporated into the system.
Perhaps the greatest damage has come to TCM in the past few hundred years as traditional remedies are being prescribed for ailments they were never meant to treat. Things like rhinoceros horn and elephant tusk are being prescribed for infertility as a TCM cure, despite that this actually goes against the tradition.
The most (in)famous of these treatments is snake oil. It originated in China, and arrived with the Chinese laborers that worked on the transcontinental railroad. There it was introduced to non-Chinese laborers and slowly developed a reputation as a panacea. It was sold by traveling salesmen who touted its efficacy and sold cases of the stuff then moved on to the next town before locals could realize they had been duped.
This practice eventually led to “snake-oil” being synonymous with medical shams. However it was only used in TCM for joint pain and arthritis. A 1989 study showed that the active ingredient, EPA, worked similarly to aspirin, but could be absorbed through the skin. So in spite of its dubious reputation in the West, it remains a common fixture in China.
In fact a bottle of snake-oil is sitting on my co-workers desk right now, she uses it to relieve mosquito bites. She doesn’t care about its chemical composition, or that it’s the camphor and not the snake oil that soothes the itch, all she cares about is that it works and to her this reinforces the efficacy of TCM.
Tomorrow we’ll be looking at the effects of TCM on Chinese cooking and endangered species (sadly those two overlap)
Tom, have you read about 方舟子before? For years, he has been exposing the myth about TCM and all sorts of fraud. Not too long ago he was attacked on street by thugs working for someone he had exposed. Quite a guy: http://blog.sina.com.cn/fangzhouzi
I was reading some TCM sites yesterday, and one was excited by the fact that 60% of the herbs used in Chinese medicine are thought to have potential applications in western med. To me this didn’t seem like a number to be so excited about. One of the biggest problems facing TCM right now is that there is no officially sanctioned brand of it, so there are always people pretending to have secret cures.
方舟子has his vision abt TCM and he did provide certain seemingly rational explanation. but it appears to me that he does not have much practical experience. he is quite a guy only in the way he criticizes. His explanation doesnt mean there are no other way to explain the same issue. i suggest that he should learn something about the exact TCM system and how TCM deal with real medical problems, but not just reading books and gathering news or information to attack something he does really know about. Undeniably there are incompetent TCM doctors out there who is ruining TCM. but a tradition that could have survived for thousands of years must have got a lot of things which is more that what ‘myth’ or science could explain.
There was a tribe in Afghanistan who was forced to move higher into the mountains during the soviet invasion. After they moved they started experiencing more deaths during childbirth. Their traditional doctor claimed that it was caused by a demon that would “steal” the placenta, their treatment was to manually remove the placenta quickly after the birth. This solved the child birth problem.
Does this mean that a demon was really stealing the placenta? their explanation of the problem and their cure worked.
However science would say that the high altitude has caused the placenta to grow abnormally large (which brought more oxygen to the fetus), the death were caused by the placenta become stuck, the treatment is manual removal.
There are many traditional practices that have value AND can be explained scientifically. If it can be demonstrated scientifically, how do we know it had any effect?
Tom,
I appreciate the condensed yet useful style of your Blog. I use a great deal of the information you provide when I am interacting with my Chinese counterparts during my visits. This blog’s topic will certainly come up next week in my visit to Zhuzhou.
So glad to hear that this is helpful. TCM is a big part of Chinese culture, and its influence goes far beyond the pharmacy and impacts daily life in surprising ways.
[…] 中国见红：中国的传统草药方，为什么有些好使有些不灵？——那些有效的中药只不过是因为其中原料恰好含有可以治好某种病症的化学成分。 […]
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Tom, I was reading 译者 just a moment ago, they translated this posting of yours, and “infamous” (referring to snake oil) is translated into “not so famous”, and I left them a note pointing that out.
Thank you for your vigilance, and willingness to read my posts in two languages 🙂
Just an example of bad translation we were talking about the other day. If a translator errs on such a basic level, imagine how erroneous he/she can be further up. Translation quality is not always reliable on 译者; if I am interested in a piece, I go to the source 🙂
[…] 原文：Ancient Chinese Herbal Recipes – Why do some work while others are useless? 时间：2011.7.13 星期三作者：Tom本文由”译者”志愿者翻译并校对 […]
[…] you are new to Traditional Chinese Medicine I suggest reading my other posts on the topic first (1, 2, 3, […]
作者批评中医的取类比象，建议作者阅读内经。
另外推荐阅读 陈存仁.我的医务生涯。
方舟子是中国人文基础教育失败的产物，食洋不化，专指这种人。
[…] some involved in TCM are joining the struggle to separate fact from fiction. Says China […]