Traditional Chinese medicine faces a tough time at home 　　but gets an enthusiastic reception abroad
　　
　　Zhang Gongyao, a professor at Central South University, recently launched an online petition calling for the removal of traditional Chinese medicine (TCM) from the country’s healthcare system. This provoked a big public outcry.
　　Some Internet users signed their names in support of the move, but things did not end there. When some well-known public figures joined the side of removing TCM from the healthcare system, the debate went wider and deeper.
　　
　　Zhang, who researches the history of scientific thought, is not an influential figure in the traditional medicine community but his supporters, according to some media reports, come mostly from the health and medical fields.
　　A battle to defend traditional medicine broke out. An outraged doctor at the hospital affiliated to the Hunan Academy of Traditional Chinese Medicine decided to sue Zhang for libel after legal consultation.
　　To calm the heated situation, Mao Qun’an, a Ministry of Health official, said at a recent press conference that people who denied the historical achievements, current function and scientific basis of traditional Chinese medicine were clearly ignorant of history.
　　“The online petition to repudiate traditional Chinese medicine is a farce,” said a spokesman for the State Administration of Traditional Chinese Medicine.
　　
　　
　　A ‘pseudoscience’?
　　
　　TRADITIONAL PHARMACY: A pharmacist dispenses traditional Chinese herbal medicines in a TCM pharmacy in Beijing
　　The key to the debate is whether TCM is a science or not.
　　He Zuoxiu, a theoretical physicist and academician of the Chinese Academy of Sciences and a reputed “fighter of pseudoscience,” said, “Traditional Chinese medicine theory, being all at sea, is a typical pseudoscience, which represents a ‘backward productivity’.”
　　According to those who advocate abolishing TCM, modern medical disciplines (i.e., Western medicine) is based on such sciences as physics, chemistry, biology and statistics. The curative effects and side effects of Western medicine can be explained and proven by its theories and clinical experiments.
　　By contrast, the yin and yang and five-element theories of TCM seem to be too abstract and metaphysical, and difficult to explain through science. What’s more, uncertainties often occur during the clinical application of TCM. For instance, in TCM, there may be 10 different treatment methods for just one disease. Besides, the performance and side effects of each TCM material hasn’t been proven through strict clinical experiments. Therefore, TCM is viewed as no more than an accumulation of experience, not a science, though it has some effective medicines and therapies.
　　Recent negative reports on TCM also have put extra pressure on it, resulting in a lessening of public trust. The most recent one happened in August, when the UK’s Medicines and Healthcare Products Regulatory Agency found that one traditional medicine, Fufang Luhui Jiaonang, contained toxic levels of mercury.
　　“The problem with TCM is its effectiveness and side effects. It will benefit the country’s medical situation to get TCM out of China’s healthcare system,” said Zhang.
　　Traditional medicine, which dates back several thousand years, used to be the quintessence of the country, and Western medicines were not popular until 1949, when the People’s Republic of China was established. Before that, TCM was predominant in the Chinese medical system. It’s no surprise then that the debasing of TCM has encountered much opposition.
　　
　　“I’m a little suspicious of traditional Chinese medicine, but what I’m pretty certain is that it has such a long history and an irreplaceable position in human medical history,” said Chen Dazhi, Deputy Director of the Organ Transplant Center at Chaoyang Hospital in Beijing.
　　Chen said that while TCM theories can’t be explained by modern science, it doesn’t necessarily mean that TCM is unscientific. It’s just a matter of time before TCM can be interpreted by current science, just as many other phenomena that used to be considered unexplainable were later proven scientifically. Even within the Western medical field there are some things that cannot be explained by modern medical theory. In addition, TCM does have good curative effects for many diseases that can’t be cured by Western medicine.
　　Song Aizhu, a doctor at the Beijing Hospital of Traditional Chinese Medicine, is keenly aware of the special curative properties of TCM. Her institution has received patients from around the world, and the cupboard in her office is stuffed with gifts sent by the many healed patients.
　　Miyuri Makabe, a 50-something Japanese woman who was badly injured in a boating accident, came to China for help after two years of Western medical treatment failed to work. “When I landed in this hospital I was like a robot with steel struts tied to my body and crutches under my armpits. I couldn’t walk without support,” she recalled.
　　After careful examination, a panel of experts decided to put her through acupuncture treatment, supplemented by some herbal remedies. The next day she showed improvement. On the third day she needed only one crutch and a week later she could go shopping. In a month she was totally cured and headed back home. Half a year later, when she returned to the hospital for follow-up treatment, she could even scamper about.
　　“Chinese medicine is so magical, I will introduce it to more people,” she said in simple Chinese.
　　Several patients at the hospital from Switzerland and Romania were randomly asked their reaction to the issue of removing TCM from China’s healthcare system. All looked surprised and shook their heads as if to say, “Why? I don’t get it.”
　　Hou Manzhen, a veteran practitioner of TCM, has his own point of view on the issue. Chinese medicine theory is built on macro philosophy while its Western counterpart is based on micro philosophy, he said. Take the common cold for example. Western medicine views it as the result of a viral infection while Chinese medicine sees it as the result of a weakening of the immune system. Thus the treatments differ. A Western doctor might suggest medicine to ease the symptoms, while his Chinese counterpart would suggest a therapy to improve the functioning of the whole body.
　　“TCM and Western medicine are actually two complementary things,” said Hou. “It’s not proper to say which one is better. TCM does have some defects, but it makes no sense to exclude it on the basis of Western medicine, and it’s unfair to traditional Chinese medicine.”
　　
　　
　　Facing a predicament
　　
　　HERBALS GO ABROAD: Beijing Tongrentang, a leading producer of traditional Chinese medicines, opened a branch store in Australia last November
　　Leaving aside the argument about the removal of traditional Chinese medicine from the Chinese healthcare system, what is clear is that TCM is now in difficulty in its place of origin―China.省略, one of China’s largest Internet portals, conducted a survey involving 20,046 respondents. When asked the question “What do you think of TCM,” 74 percent voiced their support while only 17 percent opposed it. However, when asked “Would you choose to go to a traditional medicine or Western doctor when you are sick,” about 58 percent chose Western doctors, 16 percentage points higher than the rate of those choosing TCM.
　　What’s more frustrating for TCM was another survey conducted by Wang Li, the leading surgeon at the People’s Hospital of Peking University. The survey showed that 90 percent of the respondents don’t believe in TCM any more. The reasons include TCM’s long period of treatment, complicated therapy methods and the exaggerated publicity of some TCM hospitals, she said.
　　“Pushed by the economic benefits, a few small TCM hospitals and private clinics boast they can heal any disease, which is of course impossible. This has brought a bad influence on traditional Chinese medicine,” said Song, the traditional medicine doctor.
　　“Traditional Chinese medicine is something extensive and profound, and many herbal medicines or treatment methods take the form of secret recipes, which gives an opportunity to a few designing people,” said Hou.
　　According to the certified physician law of China, one is required to have at least four years of medical school education to take the test to become a certified physician and two fifths of the test is about Western medicine.
　　Many of the most experienced TCM practitioners don’t know Western medicine or foreign languages, although they are good at curing diseases, and thus they cannot obtain the certification, which will lead to the disappearance of traditional medical wisdom when they die.
　　The present medical law enforcement and supervision system hampers the normal private practice of TCM. Even if a person dies a natural death under a private TCM practice, the practitioner will be punished if someone sues him, since he does not have certification. Another unreasonable point is that a medical accident occurring in TCM practice must be examined by Western medical technology even though the two belong to different medical systems. As a result, TCM treatments are too cautious and conservative in innovation.
　　Statistics show that the number of TCM practitioners stood at 800,000 in 1912, 500,000 in 1949 and is now below 300,000. The number of Chinese veteran TCM practitioners has dropped to the present 500 from 5,000 in the 1980s, with most of them above the age of 88.
　　Therefore, some warn that Chinese medicine is facing the loss of its legacy. But Zhang Bing, a professor at the Beijing University of Chinese Medicine, said the crisis is a “problem in progress,” and people should not be so worried about it because it will be eased with the advancement of higher education in TCM.
　　TCM has been gradually marginalized. TCM hospitals are facing a declining business, and local financial support is insufficient. In Hunan Province, the provincial fiscal revenue stood at 73.9 billion yuan in 2005 but only 5 million yuan was allocated to TCM, and the spending hasn’t seen any increase over the past 10 years.
　　“Many TCM hospitals would rather adopt Western medical treatments instead of prescribing cheap Chinese herbal medicines to survive in the business,” said Bai Zhengping, Deputy Dean of a hospital affiliated with the Hunan Academy of Traditional Chinese Medicine. It costs only 60 yuan to cure a fracture through traditional treatment but the cost for having surgery is 1,600 yuan. To earn more money, hospitals would rather put fracture patients through surgery.
　　“Most of the current TCM hospitals don’t live up to their names,” said Lu Bingkui, the former Director of the Chinese Medicine Bureau of the Ministry of Health. “They are mixed hospitals with both traditional Chinese and Western medicines.”
　　
　　A renaissance abroad
　　
　　ACUPUNCTURE MODEL: A foreign student at Nanjing University of Traditional Chinese Medicine studies acupuncture points on a bronze model with his teacher
　　The Chinese Government is aware of TCM’s difficult situation and is working on alleviating measures.
　　Traditional Chinese medicine has spread to over 130 countries and regions in the world. Global sales of Chinese herbal medicines have been increasing. According to World Health Organization statistics, in the next five to 10 years, Chinese herbal medicine sales will reach $200-300 billion worldwide. Figures from WHO also showed the annual sales of the world’s vegetable-based medicines come to about $16 billion, of which 80 percent is taken up by Japan, 15 percent by South Korea and only 3-5 percent from China. China’s herbal medicine exports stood at only $800 million in 2005.
　　While in difficulty in its home country, TCM is getting an enthusiastic reception elsewhere. According to Deng Tietao, professor at the Guangzhou University of Traditional Chinese Medicine, acupuncture is making its way into the mainstream medical care system in Britain. In the United States, acupuncture has been approved in 35 states and the District of Columbia, with over 10,000 acupuncturists and 1 million patients receiving treatment.
　　“Many countries are investing big money in the research and development of Chinese herbal medicine, which is challenging the development of Chinese herbal medicine in China,” according to a Chinese Government document concerning the future development of TCM in China.
　　In this document, which was issued in August, the government proposed detailed measures and set up objectives to protect the country’s legacy. By 2010, TCM clinics or TCM services should be set up in all the health centers at the township level; TCM legislation should be put forward and a TCM standard system should be established, and the prevention and treatment capacity of TCM for serious diseases such as diabetes, cancer and kidney diseases should be enhanced.
　　On October 22, the State Administration of Traditional Chinese Medicine announced that during the 11th Five-Year Plan (2006-10), the Central Government will invest 5 billion yuan to support the development of TCM; the investment was only 800 million yuan during last Five-Year Plan.
　　Apart from government support, it is urgent to change the current TCM education mode, experts say.
　　Currently there are 32 TCM colleges and universities in China, with 390,000 students. Five years ago, the number was a tiny 80,000.
　　“The current TCM education system focuses too much on the classics of traditional Chinese medicine, and it is adrift from clinical experiments,” said Hou, the veteran practitioner. “Medical education shouldn’t blindly stick to the classic works, it should respect the actual curative effects.”
　　Another veteran practitioner of TCM, Gao Rugui, worries about the westernization of Chinese traditional medical education. Western medical knowledge makes up the bulk of TCM students’ classes, and TCM texts are intermingled with Western medical thought, which can lead to students’ losing faith in TCM.
　　“TCM education is looking for a reasonable pattern. It’s natural to have arguments and controversy during the process. In my opinion, TCM education is moving towards a more rational direction,” said Professor Zhang.
　　The folk tradition of passing down knowledge from masters to their apprentices is also being revived. The government is setting up a high-profile TCM research and study class in Guangdong Province. The class is led by some veteran practitioners of TCM, and attended by students who have mastered basic TCM knowledge and have rich clinical experience.
　　“It’s a complex and systematic project to revive traditional Chinese medicine,” said Zhang. “I think the most important thing is to build our own TCM theory on a scientific basis. Without a clear and straight understanding of the TCM mechanism, there’s no dialogue or exchange between the two medical systems, and what we can have is only misunderstanding.”

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