There is less than meets the eye when considering traditional Chinese medicine, says Professor Edzard Ernst
'Traditional Chinese medicine is a misnomer for an artificial system of health care ideas and practices generated between 1950 and 1975 by committees in the People's Republic of China, with the aim of restructuring the vast and heterogenous heritage of Chinese traditional medicine in such a way that it fitted the principles – Marxist-Maoist type democracy and modern science and technology – on which the future of the PRC was to be built.
'TCM, as it came to be known in the West beginning with the late 1970's, reflects only a portion of the tremendously variegated body of knowledge accumulated in the preceding two millennia. While it is entirely understandable and legitimate for the Chinese leadership to select from this tradition, and to reinterpret those elements it considers helpful to build a future meaningful coexistence of modern Western and traditional Chinese ideas and practices, it is not clear whether population in Western countries wish to make the same choices when they are confronted with the legacy of the past.' [1]
These are the words of P.U. Unschuld, a medical historian who is widely appreciated as the most authoritative expert in Chinese medicine. Unschuld has repeatedly shown that:
• The Marxist founders of the PRC thought less than highly of China's ‘old medicine'; one even called it a ‘millennia-old dung heap'
• For political and economical reasons they could not abolish the ‘old medicine', even though they would have like to
• Instead they created ‘TCM' which is an artefact composed of traditions that do not belong together and have no common concept.
When I first visited China, I think this was in 1980, I was not aware of this historical background. Yet I did certainly get the impression that the Chinese people (patients and doctors alike) would have gladly abandoned TCM, if they could have afforded western medicines, and that integration of the two systems was not a reality but an impression the Chinese officials were instructed to give to foreign visitors. These impressions were confirmed during a subsequent visit and through candid discussions with Chinese researchers.
But they are only impressions! How can we research this subject more systematically? A recent survey [2] might be a step in the right direction: 170 students from China visiting UK universities were asked which system they preferred. The results show quite clearly that participants preferred western medicine over TCM while in the UK.
And the message from all this? Let me formulate it as a question: Should we perhaps be more critical about the value of TCM and ask ourselves whether we are not in danger of over-estimating it mainly because we perceive it to rely on ‘ancient wisdom'?
Professor Edzard Ernst is professor of complementary medicine at the Peninsula Medical School, University of Exeter.
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