For many Westerners “Traditional Chinese Medicine” brings to mind an image something like this
However this is not what TCM looks like in most of China. At the hospital where I work there is a TCM department, their patients are mostly elderly and have been referred for pain management, not yin and yang disharmony. TCM is shifting from local practitioners who collected their own herbs to massive TCM pharmaceutical companies, the entire system is changing. I thought today we should wrap up our look at TCM by discussing its possible future.
It may surprise many of my western readers to learn that Chinese herbal medicines usually look nothing like that picture above. Now most cures come in the form of a pill, a powder, or a pre-mixed tonic; gone are the days of an individualized prescription.
As TCM pharmaceutical companies strive to package the herbs in a more palatable form, they are slowly moving away from whole herbs to isolated active ingredients. This is exactly what happened in Western Medicine almost 200 years ago.
The major difference that remains is the approach the two systems take to dosage, as western medicine is typically a once daily pill. TCM prescriptions however still require multiple doses (highest I’ve seen is 6/day), but this is changing as Chinese society becomes more focused on convenience.
For decades TCM has insisted that modern scientific methods could not be used to evaluate the efficacy of TCM cures, because their diagnostic approaches were completely different. For example it is not uncommon for similar symptoms, which may be diagnosed as one disease in modern medicine, while it could be seen as distinctly different problems in TCM.
However recent labeling requirements by the drug regulators in the US and the EU require scientific studies that show these are effective in treating the ailments described. In the interest of profits many TCM pharm. companies have dropped their previous reservations about these tests in an effort to reach new markets.
Being able to claim that herbal cures are effective by western standards implies that the TCM diagnostic system is not necessary. If you show that a certain herb is effective in combating bacterial infections, means that the root cause was never an excess of “heat”.
I think in the next few decades, TCM’s role will shift away from diagnostic work, but will continue to produce medications that are based on traditional ideals.
This is one aspect of TCM that will remain in-use and keep its distinct identity (partially because of its popularity abroad at the moment). However as the TCM diagnostic system declines, acupuncture will shift from being used to re-calibrate the system, and become used largely for subjective treatments (pain management, nausea reduction…).
Currently my hospital is experimenting with the clinical use of herbs and acupuncture for similar purposes, and are having some good results.
Interesting note for scientific minded people, acupuncture methods are tested against sham acupuncture (needles in non-meridian points) to help control the placebo effect.
I am hopeful for the future inclusion of traditional knowledge in modern medicine. TCM is a treasure trove of cures that were discovered over thousands of years of experimentation, and soon the useful bits will be absorbed into modern medicine to benefit all people, without the false promises and scams that currently affect TCM.
Note: I am basing these conclusions on discussions I’ve had with employees of my hospital’s TCM department, as well as discussions I’ve had with students and co-workers about their views on these products, which were largely negative.