Traditional Chinese Medicine (TCM) is the umbrella term for modalities historically used in ancient China. TCM includes many therapeutic and some diagnostic modalities. Even though, these modalities differ in many respects, they are claimed to have in common that they are based on assumptions most of which originate from Taoist philosophy:
- The human body is a miniature version of the universe.
- Harmony between the two opposing forces, yin and yang, means health.
- Disease is caused by an imbalance between these forces.
- Five elements—fire, earth, wood, metal, and water—symbolically represent all phenomena, including the stages of human life, and explain the functioning of the body and how it changes during disease.
- The vital energy, qi or chi, flows through the body in meridians, is essential for maintaining health.
TCM is a construct of Mao Zedong who lumped all historical Chinese treatments together under this umbrella and created the ‘barefoot doctor’ to practice TCM nationwide – not because he believed in TCM, but because China was desperately short of real doctors and needed at least a semblance of healthcare.
Over the past few years, China has been aggressively promoting TCM for expanding its global influence and for a share of the estimated US$50-billion global market (of products of dubious quality). A recent article in ‘Nature’ explains that the WHO’s governing body, the World Health Assembly, is set to adopt the 11th version of the organization’s global compendium — known as the International Statistical Classification of Diseases and Related Health Problems (ICD). For the first time, the ICD will include information about TCM. Chapter 26 of the ICD will feature a classification system on TCM, largely based not on science or facts, but on obsolete nonsense.
The WHO’s support applies to all traditional medicines, but its relationship with Chinese medicine, and with China, has grown especially close, in particular during the tenure of Margaret Chan, who ran the organization from 2006 to 2017 and made sure that several documents favourable to TCM were passed. The WHO’s declarations about traditional medicine are puzzling. Various of these WHO documents call for the integration of “traditional medicine, of proven quality, safety and efficacy”, while being silent as to which traditional medicines and diagnostics are proven. Wu Linlin, a WHO representative in the Beijing office, told Nature that the “WHO does not endorse particular traditional and complementary medicine procedures or remedies”.
But this is evidently not the case and in sharp contrast to the WHO’s actions in other areas. The agency provides, for instance, specific advice on what vaccines and drugs to use and what foods to avoid. With traditional medicines, however, such specifics are missing. The message therefore can only be that the WHO endorses TCM as safe and effective.
The evidence, however, tells us a different story. On this blog, we have repeatedly discussed that:
- the clinical trials of TCM are often of poor quality,
- there are several good reasons why one has to be very sceptical about research coming out of China,
- critics are silenced,
- in general, the evidence on TCM is neither positive nor trustworthy.
China’s drug regulator gets more than 230,000 reports of adverse effects from TCM each year, and Chinese herbal medicines carry multiple direct risks:
- one or more ingredients can be toxic,
- some have been shown to be contaminated with toxic materials such as heavy metals,
- others are adulterated with synthetic drugs such as steroids,
- others again can interact with prescription drugs taken concomitantly,
- and not to forget, the risk for endangered species.
To this, we have to add the indirect risk of employing useless treatments for otherwise treatable conditions.
In view of all this, the WHO’s endorsement of TCM and its obsolete concepts is not just not understandable, it is a dangerous step backwards and, in my view, even intolerable.
Now that the Australian Health Practitioner Regulation Agency controls the management of TCM for the protection of the Australian public. China will not be able to silence researchers based in Australia and most Commonwealth countries.
It is unbelievable but unfortunately understandable. When the WHO published their “traditional medicine strategy 2014-2023” http://www.who.int/medicines/publications/traditional/trm_strategy14_23/en/ I was shocked beyond believe. They called for the integration of homeopathy, TCM, ayurveda etc which is clearly a step back into the dark ages.
But because my former employer, the National Institute of Complementary Medicine, Australia was over the moon with this WHO report and started using it left, right and centre for what they were doing as being ‘mandated directly from the WHO’ I became quite suspicious. I investigated the issue and found that one of the NICM’s adjuncts, the Canadian naturopath Michael Smith was one of the people in charge of drafting this WHO report. So somehow they managed to convince the WHO to trust naturopaths to publish an extremely important WHO strategy document. How they managed to do this, I don’t have the foggiest. Here is an article that I’ve written about this issue – these people have infiltrated everywhere.
Numerous of people in Asia still use traditional medicine in spite of the argument that traditional medicine lack of scientific evidence. They do not rely on the traditional treatment if not effective. Please do not treat them foolish. Asian people spend money for the traditional treatment. It is not free. The reality is that numerous people in Asia and numerous people in India have been relied on the traditional medicine treatment for a longtime. They have not been captured in WHO statistics although they have been doing the job for a long time. Most of countries face with huge financial burden for health cost in the significant increasing aging population. What make worse, many people turn away from conventional medicine due to the side effects. What can you suggest in this environment? Stupid peoples only believe in the tangible things only. If based on writer’s theory, should people abolish all the church because people cannot prove God? It is same analogy to me. When you have God in your mind, you can see God. In the same way, when you have no experience of traditional medicine, you only think negative way. This is my opinion.
“should people abolish all the church because people cannot prove God? ”
people might want to abolish churches because there is no god.
Quite obviously, former WHO director Margaret Chan has played a big part in this scandal. According to wiki, unscientific promotion of TCM is not the only “great” achievement of her.
As it seems, she preferred to act like a submissive Chinese politician rather than like a physician indirectly responsible for the well-being of millions of people. I wonder what went wrong in the WHO organization that led to election of such a person to the position of director-general for two terms, and how such a mistake could be prevented in the future.
I met her several times. she struck me as someone who has little expertise and is 100% devoted to her peers in China. in other words, it felt as though she was an entirely political appointment.
As I see it, her promotion of TCM directly violates at least three of the nine basic principles of the WHO (b, g, h):
a. Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
b. The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.
c. The health of all peoples is fundamental to the attainment of peace and security and is dependent on the fullest co-operation of individuals and States.
d. The achievement of any State in the promotion and protection of health is of value to all.
e. Unequal development in different countries in the promotion of health and control of diseases, especially communicable disease, is a common danger.
f. Healthy development of the child is of basic importance; the ability to live harmoniously in a changing total environment is essential to such development.
g. The extension to all peoples of the benefits of medical, psychological and related knowledge is essential to the fullest attainment of health.
h. Informed opinion and active co-operation on the part of the public are of the utmost importance in the improvement of the health of the people.
i. Governments have a responsibility for the health of their peoples which can be fulfilled only by the provision of adequate health and social measures.
Several of the other basic principles are negatively affected indirectly by TCM promotion.
A person with such clear nationalistic interests should have never been able to become director of the World (!) Health Organization, and certaily not for two (!) terms.
This headline piece, and subsequent contributions deserve the widest possible audience.
Can a paper based on them be worked up for publication in BMJ/JAMA/comparable journals of repute?
If not, or such a paper is rejected, we should be told!
This false medicine and its political basis must be exposed. Please.
if you draft something (on the basis of my post), I would join as co-author
I always believed that the NICM in Australia is by no means the only organisation who strives to integrate quackery, but they are probably one of the most dangerous organisations to do so. A quick google search using “Margaret Chan” and “Alan Bensoussan”, the latter being the director of the NICM reveals quite a number of documents dating back to early 2000. During all of their working group sessions and collaboration the central drive was the integration of TCM/traditional medicines.
It would be interesting to see if the WHO cite the TGA as an example of the successful integration of TCM. The TGA quite recently approved many TCM ‘conditions’ in their approved list of indications. These people are known to rub each other’s backs, with the NICM lobbying all that is alive referring to the WHO directive (2014) to integrate TCM etc (a report in which they had a big stake compiling) with conventional healthcare, and I guess now WHO will return the favour and cite the TGA as a success story and the reason why TCM is included within the ICD. But all of this has been a long time coming. Below is an abstract of a symposium held in 2008 (interesting to see that the TGA was already involved back then).
“This symposium, which attracted some 200 delegates, focused on the role that Traditional, Alternative and Complementary Medicines play in modern and complementary healthcare. This symposium first ‘showcased’ developments in TACM and then reviewed the progress in development and regulation of this increasingly important sector of medicines. The symposium was co-chaired by Professor David Briggs (Office of complementary Medicines, TGA Australia) and Professor Alan Bensoussan (National Institute of Complementary Medicine, Australia), and brought together experts in TACM from all continents.”
Here are some articles dealing with my own investigation:
The WHO is the health agency of the United Nations. As such it is primarily a political body, just like its parent, however much it sometimes tries to make worthy noises.
The inclusion of TCM in the ICD is clearly a scandal on an enormous scale, but the WHO has a lot of prior form in pushing political agendas ahead of its publicly perceived primary function as a global medical authority. An article published last year described the WHO as ‘no longer fit for purpose’. And where China is concerned, political problems have influenced the WHO’s behaviour at least as far back as 2003.
The interface between politicians and science has always been a murky one. If folk like Richard Rawlins and Edzard Ernst make suitable noises the issue will doubtless be aired: then soon forgotten and left to fester.
2003 just happened to be the year that the WHO published “Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials”. The Chinese TCM practitioner/author discounted negative sham controlled studies as invalid and excluded them from the review, but included both ramdomised and non-ramdomised RCTs.
Many acupuncture organisations continue to quote this scam of a review as WHO endorsement of their SCAM treatment.
That should of course read: randomised and non-randomised controlled trials.
The World Health Assembly has not yet adopted the IDC. This happens next year. Is there still a small chance that the Assembly may come back with a “wait… what?” response?
I know; this is why it is important to generate some opposition.
Maybe an (open) letter undersigned by a million scientists might convince them?
Great idea! I would sign immediately!
This should happen as soon as possible, since the recent NATURE article should have made many scientists aware of this scandal, who did not know about it before (like e.g. myself).
But who could coordinate such a global effort?
Being a member, I could ask the GWUP, but I am not sure that this would be the right address.
@Norbert Aust, if you read this, what is your opinion on this?
Hmm… Another point is the rather vague call for the integration of “traditional medicine, of proven quality, safety and efficacy”. Apparently it doesn’t describe what is proven, safe and has efficacy.
Would this not open things up for examination and reasonable demands for proof of claims?
I once contemplated writing a letter directly to Xi Jinping who is obviously the driving force behind the globalisation of TCM. For some reason, actually quite a number of reasons, I decided against it. But maybe if we can get a million scientists together (incl Chinese scientists) an open letter to the WHO and CCP might have some sort of impact.
just saw an article with a promising title: “Policies on Chinese Medicine in China May Have Enlightenments to Complementary and Alternative Medicine in the World” (https://link.springer.com/article/10.1007/s11655-018-3008-0?wt_mc=alerts.TOCjournals&utm_source=toc&utm_medium=email&utm_campaign=toc_11655_24_10)
here is its abstract:
From the event of TU You-you winning the Nobel Prize, this paper briefly reviewed the history of formation and development of policies on Chinese medicine (CM) in China. On the basis of analyzing the causes of policies on CM, it is believed that policies on CM in China may have 4 kinds of enlightenments to the development of complementary and alternative medicine (CAM) in the world. Forming the political advantages of policy-making by main leaders of the country attaching importance to CAM; implementing a diversified health care system policy for the goal of maximizing people’s health interests; ensuring development of CAM by the coerciveness of law and the timeliness of policy adjustment; and promoting the protection and mining, sorting out and improving of CAM based on open and comprehensive policies.
THIS IS AWFUL ON SO MANY LEVELS!
The pharmacology of herbs reveals quite a bit about the underlying mechanisms of Chinese medicine. Ive been to the labs, seen the research in person, and know many researchers in this field. There is good and bad. Ill be the first to agree on that. Are you seeing nonsense in the western tcm world? Yes. There is a lot of nonsense in how its been sold. You are right that it should raise a few red flags. That said there may be very useful aspects which may have the potential to uplift medicine as a whole.
Here is a 5 part series I did on the underlying physiology of tongue diagnosis. The references are on the website. I invite you to listen simply because as someone who loves medicine, I genuinely think you might enjoy it. https://botanicalbiohacking.com/blog/2019/3/2/biology-of-tongue-diagnosis-pt-1
As a medical doctor and currently reading TCM during my freetime, i agree entirely. TCM itself is based on “Syndromes” composed of different symptoms which i assume tcm fanatics just pick up at random and put them together. They do not necessarily make any sense. For instance, “heat within the heart” usually presents itself as mouth ulceration, anxiousness and dysuria (imagine putting symptoms from 3 different systems together).
That being said, TCM herbs by itself do present with mechanism of actions (albeit many). They can prove to be rather dangerous due to the wide range of MOA. Ancient formulas which have been used by TCM for thousands of years have proved to be a trash. A formula for e.g for common cold can consist anywhere from 4-20 herbs. Within the herbs, there could perhaps only be 1-2 that actually have particular mechanism of actions which targets 1-2 symptoms of common cold itself. If the TCM committee wants to improve itself, these have to be changed.