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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.
A few months ago my friend told me that she had a small tumor. The doctor said that it was benign and she could either have it removed with an operation, or try to reduce its size using Chinese medicine. She opted for the Chinese medicine. 3x’s a day for months she drank the thick brown bitter liquid which was distilled from bear bile, birds nests and shark fins.
Now I try to keep an open mind about alternative medicine, and I think there are many things in Chinese medicine that have promise for medical applications, this however doesn’t seem to be one of those times. For four months my co-worker wasted her money on this concoction with no results. The sad thing is I know the hospital is selling this “treatment” partially because of the money they receive in exchange for pushing this product. We just hide behind the name of TCM (Traditional Chinese Medicine) when there is no clinical proof that this is in any way an effective medical treatment.
These aren’t just my opinions either, many Chinese doctors who have been trained in “western” medicine worry about the effects of TCM too. One mentioned that often the patients are unaware of the side-effects of the traditional cures, and arrive in our hospital with liver or renal failure. Even the TCM doctor pointed to the fact that many people are graduating with only 3 months of study and calling themselves traditional healers, when really an apprenticeship and study takes almost as much time as becoming a doctor.
Of the 6 doctors I talked with, 3 of them said they would never take TCM treatments, 2 of them said they would take Chinese herbs for a cold or minor illness, and only one said she would take them for any serious disease (my friend who took the drugs for her tumor).
All of the doctors though agreed that they would like to see more regulations concerning TCM to protect the reputation of the practice. The TCM doctor said that he was very disappointed to see how commercialized it had become in the past decade, and how easily universities were handing out diplomas.
The TCM doctor was saying that he saw TCM’s role as accompanying Western medicine in a pain management role. For example, chemotherapy patients often struggle with side-effects which, according to patient reports, can be better controlled with acupuncture for pain and herbs for stomach problems.
Ultimately more clinical research will be useful in proving that there is value in TCM, protecting the integrity of the practice, and at the same time will help to protect Chinese patients from “cures” that delay them from getting proper treatment.