Dr. Jing Wang is the sixth generation of traditional Chinese medicine practitioners in her family. Her grandfather learned how to mix and boil herbs from an old village doctor.
Wang herself graduated from Beijing University of Chinese Medicine. During her Ph. D program, she spent two years at Yale University researching cancer. Now, as a physician at Dongzhimen Hospital, she’s interested in applying integrated Chinese and Western medicine to combat the disease.
Her experience exemplifies how traditional Chinese medicine has moved closer to Western facilities, practices and standards in the past years. Doctors and representatives of traditional medicine are considering a set of standards to test its practices and guarantee its efficacy.
Some argue that traditional medicine should focus on extracting active substances from plants – like how Tu Youyou discovered artemisinin and won China’s first Nobel Prize in medicine last year.
But critics say that standardization risks killing the traditional art, which may entail boiling concoctions of 10 to 20 herbs selected by therapists based on individual symptoms.
“We have to ask ourselves, what is it about the tradition that is worth sustaining,” said Dr. Vivienne Lo of the University College of London China Centre for Health and Humanity. She then gave the example of a revered traditional medicine practitioner whose students gather around to watch how he prepares various concoctions for his patients.
“His art cannot be standardized. We try to standardize, we try to do everything according to the boxes, but then you lose the art,” Lo said.
Lo and Wang were among a group of specialists on a panel about the benefits and downfalls of standardizing traditional Chinese medicine. The event was hosted at the World Health Organization offices in Beijing in late February and organized by the Royal Asiatic Society, Beijing.
Principles and History
Traditional Chinese medicine is rooted in two ancient theories: the harmony of yin and yang and the Five Elements.
Yin and yang represent the balance of opposing and complementary forces in one’s body. Chinese medicine employs four treatment strategies in relation to the yin and yang: tone the yang; tone the yin; eliminate excessive yang; and eliminate excessive yin.
The Five Elements are wood, fire, earth, metal and water. In traditional Chinese medicine, they represent the relationship between the human body and nature. Practitioners believe different parts of the body are correlated to the elements and to natural structures. For example, doctors will use a tree’s leaves to treat the head and the respiratory system; the branches for the joints; the bark for the skin; and the fruit for the hair.
Some of the earliest documents indicating traditional Chinese medicine practices were discovered in an imperial tomb from 168 BC in Hunan province. They included methods to boost the qi – an energy of well-being that circulates within the body. Acupuncture, moxibustion and herbal therapy have been documented through the centuries and are still used today in traditional Chinese medicine.
In the first part of the 20th century, Chinese medicine looked like it would become obsolete in a country that valued science more and more.
“Everyone at that time agreed that Chinese medicine had no future,” Paul Unschuld, a historian of Chinese medicine at the Charit Hospital in Berlin, told The New York Times. “Ideas like yin-yang, the Five Elements “all of that was considered backwards.”
But Chairman Mao declared Chinese medicine and pharmacology a “great treasure house,” demanding at the same time that it modernize. He set up traditional Chinese hospitals, schools and research institutions. Still, Western medicine prevailed: Last year, China had 23,095 hospitals, of which 2,889 specialized in Chinese medicine, according to the Times.
The main difference between traditional Chinese medicine and Western medicine is philosophical, Wang said: traditional Chinese doctors treat primarily according to the symptoms, while Western doctors treat according to the disease.
The two approaches are being integrated in traditional Chinese hospitals. Wang uses traditional medicine to improve the quality of life for her cancer patients; reduce the side effects of conventional chemotherapy; as well as reverse the multi-drug resistance in some patients.
Yet traditional Chinese medicine is still often attacked as being non-scientific, its methods and treatments untested and unpatented.
Traditional Chinese medical societies and practitioners are looking at ways to standardize the practices so they become more widely accepted around the world.
Zou Jianhua, the World Federation of Chinese Medicine Societies’ director of academic exchange, said the organization needs to use modern language to explain the practice and mechanisms of traditional Chinese medicine. The organization has members in 61 countries.
“It’s important to develop international standards that can guarantee that traditional medicine really follows accepted standards, which should be at the highest (levels),” said Bernhard Schwartl?nder, the World Health Organization Representative in China.
But Lo of the University College of London argued that regulation constricts traditional medicine.
“If the substances are not dangerous, people should respect the traditions that were passed through generations,” she said. “What needs to be regulated is the trade, not the practice.”
Specialists also considered focusing on extracting active ingredients from natural remedies, as Nobel laureate Tu did with artemisinin, which was extracted from sweet wormwood.
There, too, opinions vary. Some believe practitioners should research the herbs using a modern scientific approach. But others claim that would mean disrespecting the cultural heritage of Chinese medicine.
“I feel happiness and sorrow,” Liu Changhua, a professor of history at the China Academy of Chinese Medical Sciences, said regarding Tu’s Nobel Prize, according to the Times. “I’m happy that the drug has saved lives, but if this is the path that Chinese medicine has to take in the future, I am sad.”