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Traditional Chinese medicine

Traditional Chinese medicine (TCM) is an alternative medical practice drawn from traditional medicine in China. It has been described as pseudoscientific, with the majority of its treatments having no known mechanism of action.[1][2]

"Chinese medicine" redirects here. For the practice of medicine in modern China, see Medicine in China.

Traditional Chinese medicine

"Chinese medicine"

Zhōngyī

Zhōngyī

Chung1-i1

Jūng yī

Zung1 ji1

Tiong-i

Tiong-i

Y học cổ truyền Trung Quốc
Đông y
thuốc Bắc
thuốc Tàu

醫學古傳中國
東醫
𧆄北
𧆄艚

중의학

中醫學

漢方

かんぽう

Kampo

Kampo

Medicine in traditional China encompassed a range of sometimes competing health and healing practices, folk beliefs, literati theory and Confucian philosophy, herbal remedies, food, diet, exercise, medical specializations, and schools of thought.[3] In the early twentieth century, Chinese cultural and political modernizers worked to eliminate traditional practices as backward and unscientific. Traditional practitioners then selected elements of philosophy and practice and organized them into what they called "Chinese medicine" (Chinese: 中医 Zhongyi).[4] In the 1950s, the Chinese government sponsored the integration of Chinese and Western medicine,[5] and in the Great Proletarian Cultural Revolution of the 1960s, promoted Chinese medicine as inexpensive and popular.[6] After the opening of relations between the United States and China after 1972, there was great interest in the West for what is now called traditional Chinese medicine (TCM).[7]


TCM is said to be based on such texts as Huangdi Neijing (The Inner Canon of the Yellow Emperor),[8] and Compendium of Materia Medica, a sixteenth-century encyclopedic work, and includes various forms of herbal medicine, acupuncture, cupping therapy, gua sha, massage (tui na), bonesetter (die-da), exercise (qigong), and dietary therapy. TCM is widely used in the Sinosphere. One of the basic tenets is that the body's qi is circulating through channels called meridians having branches connected to bodily organs and functions.[9] There is no evidence that meridians or vital energy exist. Concepts of the body and of disease used in TCM reflect its ancient origins and its emphasis on dynamic processes over material structure, similar to the humoral theory of ancient Greece and ancient Rome.[10]


The demand for traditional medicines in China was a major generator of illegal wildlife smuggling, linked to the killing and smuggling of endangered animals.[11] However, Chinese authorities have in recent years cracked down on illegal wildlife smuggling, and the industry has increasingly turned to cultivated alternatives.[12][13]

Critique

Historians of science have developed the study of medicine in traditional China into a field with its own scholarly associations, journals, graduate programs, and debates with each other.[47] Many distinguish "medicine in traditional China" from the recent traditional Chinese medicine (TCM), which took elements from traditional texts and practices to construct a systematic body. Paul Unschuld, for instance, sees a "departure of TCM from its historical origins." [48] What is called "Traditional Chinese Medicine" and practiced today in China and the West is not thousands of years old, but recently constructed using selected traditional terms, some of which have been taken out of context, some badly misunderstood. He has criticized Chinese and Western popular books for selective use of evidence, choosing only those works or parts of historical works that seem to lead to modern medicine, ignoring those elements that do not now seem to be effective.[49]


A 2007 editorial the journal Nature wrote that TCM "remains poorly researched and supported, and most of its treatments have no logical mechanism of action."[2][50] Critics say that TCM theory and practice have no basis in modern science, and TCM practitioners do not agree on what diagnosis and treatments should be used for any given person.[9] A Nature editorial described TCM as "fraught with pseudoscience".[2] A review of the literature in 2008 found that scientists are "still unable to find a shred of evidence" according to standards of science-based medicine for traditional Chinese concepts such as qi, meridians, and acupuncture points,[51] and that the traditional principles of acupuncture are deeply flawed.[52] "Acupuncture points and meridians are not a reality", the review continued, but "merely the product of an ancient Chinese philosophy".[53] In June 2019, the World Health Organization included traditional Chinese medicine in a global diagnostic compendium, but a spokesman said this was "not an endorsement of the scientific validity of any Traditional Medicine practice or the efficacy of any Traditional Medicine intervention."[54][55][56]


A 2012 review of cost-effectiveness research for TCM found that studies had low levels of evidence, with no beneficial outcomes.[57] Pharmaceutical research on the potential for creating new drugs from traditional remedies has few successful results.[2] Proponents suggest that research has so far missed key features of the art of TCM, such as unknown interactions between various ingredients and complex interactive biological systems.[2] One of the basic tenets of TCM is that the body's qi (sometimes translated as vital energy) is circulating through channels called meridians having branches connected to bodily organs and functions.[9] The concept of vital energy is pseudoscientific. Concepts of the body and of disease used in TCM reflect its ancient origins and its emphasis on dynamic processes over material structure, similar to Classical humoral theory.[10]


TCM has also been controversial within China. In 2006, the Chinese philosopher Zhang Gongyao triggered a national debate with an article entitled "Farewell to Traditional Chinese Medicine", arguing that TCM was a pseudoscience that should be abolished in public healthcare and academia. The Chinese government took the stance that TCM is a science and continued to encourage its development.[58]


There are concerns over a number of potentially toxic plants, animal parts, and mineral Chinese compounds,[59] as well as the facilitation of disease. Trafficked and farm-raised animals used in TCM are a source of several fatal zoonotic diseases.[60] There are additional concerns over the illegal trade and transport of endangered species including rhinoceroses and tigers, and the welfare of specially farmed animals, including bears.[61]

Yin vacuity (also termed "vacuity-heat"): heat sensations, possible sweating at night, insomnia, dry pharynx, dry mouth, dark urine, and a "fine" and rapid pulse.

[69]

Yang vacuity ("vacuity-cold"): aversion to cold, cold limbs, bright white complexion, long voidings of clear urine, diarrhea, pale and enlarged tongue, and a slightly weak, slow and fine pulse.

[68]

Fire () = Heart (; xīn) and Small Intestine (小腸; xiaǒcháng) (and, secondarily, Sānjiaō [三焦, "Triple Burner"] and Pericardium [心包; xīnbaò])

Earth () = Spleen (; ) and Stomach (; weì)

Metal () = Lung (; feì) and Large Intestine (大腸; dàcháng)

Water () = Kidney (; shèn) and Bladder (膀胱; pángguāng)

Wood () = Liver (; gān) and Gallbladder (; dān)

"Upflaming Liver fire" (肝火上炎; gānhuǒ shàng yán): Headache, red face, reddened eyes, dry mouth, nosebleeds, constipation, dry or hard stools, profuse menstruation, sudden or deafness, vomiting of sour or bitter fluids, expectoration of blood, irascibility, impatience; red tongue with dry yellow fur; slippery and string-like pulse.[68]

tinnitus

Inspection focuses on the face and particularly on the tongue, including analysis of the tongue size, shape, tension, color and coating, and the absence or presence of teeth marks around the edge.

Auscultation refers to listening for particular sounds (such as wheezing).

Olfaction refers to attending to body odor.

Inquiry focuses on the "seven inquiries", which involve asking the person about the regularity, severity, or other characteristics of: chills, fever, perspiration, appetite, thirst, taste, defecation, urination, pain, sleep, , leukorrhea.

menses

Palpation which includes feeling the body for tender , and the palpation of the wrist pulses as well as various other pulses, and palpation of the abdomen.

A-shi points

The classification according to the (四气; sì qì): hot, warm, cool, or cold (or, neutral in terms of temperature)[29] and hot and warm herbs are used to treat cold diseases, while cool and cold herbs are used to treat heat diseases.[29]

Four Natures

The classification according to the , (五味; wǔ wèi, sometimes also translated as Five Tastes): acrid, sweet, bitter, sour, and salty.[29] Substances may also have more than one flavor, or none (i.e., a "bland" flavor).[29] Each of the Five Flavors corresponds to one of zàng organs, which in turn corresponds to one of the Five Phases.[29] A flavor implies certain properties and therapeutic actions of a substance; e.g., saltiness drains downward and softens hard masses, while sweetness is supplementing, harmonizing, and moistening.[29]

Five Flavors

The classification according to the meridian – more precisely, the zàng-fu organ including its associated meridian – which can be expected to be primarily affected by a given compound.

[29]

The categorization according to the specific function mainly include: exterior-releasing or exterior-resolving,[29] heat-clearing,[29][163] downward-draining,[163] or precipitating[29] wind-damp-dispelling,[29][163] dampness-transforming,[29][163] promoting the movement of water and percolating dampness[163] or dampness-percolating,[29] interior-warming,[29][163] qi-regulating[163] or qi-rectifying,[29] dispersing food accumulation[163] or food-dispersing,[29] worm-expelling,[29][163] stopping bleeding[163] or blood-stanching,[29] quickening the Blood and dispelling stasis[163] or blood-quickening,[29] transforming phlegm, stopping coughing and calming wheezing[163] or phlegm-transforming and cough- and panting-suppressing,[29] Spirit-quieting,[29][163] calming the liver and expelling wind[29] or liver-calming and wind-extinguishing[29] orifice-opening[29][163] supplementing[29][163] which includes qi-supplementing, blood-nourishing, yin-enriching, and yang-fortifying,[29] astriction-promoting[163] or securing and astringing,[29] vomiting-inducing,[163] and substances for external application.[29][163]

[163]

: introspective and meditative

Neigong

Waigong: external energy and motion

Donggong: dynamic or active

Jinggong: tranquil or passive

[233]

. World Health Organization. 2013. hdl:10665/92455. ISBN 9789241506090. Retrieved 1 April 2023.

WHO traditional medicine strategy: 2014-2023

Baran GR, Kiana MF, Samuel SP (2014). "Chapter 2: Science, Pseudoscience, and Not Science: How Do They Differ?". Healthcare and Biomedical Technology in the 21st Century. Springer. pp. 19–57. :10.1007/978-1-4614-8541-4_2. ISBN 978-1-4614-8540-7.

doi

Barnes, Linda L. (2005). Needles, Herbs, Gods, and Ghosts: China, Healing, and the West to 1848. Cambridge, Mass: Harvard University Press.  0674018729. Shows early use of Chinese medicine not always perceived as "Chinese."

ISBN

Baum, Emily (2020). "Medicine and Public Health in Twentieth-Century China: Histories of Modernization and Change". History Compass. 18 (7). :10.1111/hic3.12616. S2CID 225622823.

doi

Liu, Lihong (2019). Classical Chinese Medicine. Translated by Weiss, Gabriel; Henry Buchtel; Sabine Wilms. Shatin, NT Hong Kong: Chinese University of Hong Kong Press; distributed by Columbia University Press.  9789882370579.

ISBN

; Sivin, Nathan (2002). The Way and the Word: Science and Medicine in Early China and Greece. New Haven: Yale University Press. ISBN 0300092970.

Lloyd, G. E. R.

Lo, Vivienne; Stanley-Baker, Michael, eds. (2022), Routledge Handbook of Chinese Medicine, New York: Routledge,  9780415830645 Online Open Access. 51 articles on history of Chinese medicine; called "impressive and essential" for latest scholarship and trustworthy bibliographic sources. "(Review) H-Sci-Med-Tech, July 2023.

ISBN

McGrew, Roderick. Encyclopedia of Medical History (1985), brief history on pp. 56–59

(2000). Sivin N (ed.). Part VI: Medicine. Science and Civilisation in China. Vol. 6, Biology and Biological Technology. Cambridge University Press. ISBN 978-0-521-63262-1. OCLC 163502797.

Needham J

Palmer, James (13 June 2013), , Aeon

"Do Some Harm"

(Winter 2020), "Chinese Philosophy and Chinese Medicine", in Zalta, Edward N. (ed.), The Stanford Encyclopedia of Philosophy, Metaphysics Research Lab, Stanford University

Raphals, Lisa

Shelton, Tamara Venit (2019). Herbs and Roots: A History of Chinese Doctors in the American Medical Marketplace. New Haven: Yale University Press.  9780300249408.

ISBN

Unschuld, Paul (1986). Nan-Ching: The Classic of Difficult Issues. Berkeley: University of California Press.  9780520053724.

ISBN

—— (1986a). Medicine in China: A History of Pharmaceutics. Berkeley: University of California Press.  9780520050259.

ISBN

—— (2000). Medicine in China: Historical Artifacts and Images. Munich: Prestel.  9783791321493.

ISBN

—— (2018). Traditional Chinese Medicine: Heritage and Adaptation [Traditionelle chinesische Medizin (2013)]. Translated by Bridie J. Andrews. New York: Columbia University Press.  9780231175005.

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—School of Chinese Medicine, Hong Kong Baptist University (in Chinese)

Medicinal Plant Images Database

—School of Chinese Medicine, Hong Kong Baptist University (in Chinese)

Chinese Medicine Specimen Database

PDF, 133 pages; compiled by the Association Québécoise des Thérapeutes Naturels (AQTN)

Literary Review Compilation on Traditional Chinese Medicine