Why oriental medicine

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Overseas, China has opened TCM centres in more than two dozen cities, including Barcelona, Budapest and Dubai in the past three years, and pumped up sales of traditional remedies. And the WHO has been avidly supporting traditional medicines, above all TCM, as a step towards its long-term goal of universal health care. According to the agency, traditional treatments are less costly and more accessible than Western medicine in some countries. Many Western-trained physicians and biomedical scientists are deeply concerned, however.

A pharmacy in a traditional-medicine hospital in Beijing dispenses medications. TCM is based on theories about qi, a vital energy, which is said to flow along channels called meridians and help the body to maintain health.

In acupuncture, needles puncture the skin to tap into any of the hundreds of points on the meridians where the flow of qi can be redirected to restore health. Treatments, whether acupuncture or herbal remedies, are also said to work by rebalancing forces known as yin and yang. Practitioners of TCM and Western-trained physicians have often eyed each other suspiciously.

The Western convention is to seek well-defined, well-tested causes to explain a disease state. And it typically requires randomized, controlled clinical trials that provide statistical evidence that a drug works. From the TCM perspective, this is too simplistic. Factors that determine health are specific to individuals.

Drawing conclusions from large groups is difficult, if not impossible. And the remedies are often a mix of a dozen or more ingredients with mechanisms that cannot, they say, be reduced to a single factor.

Organizations steeped in the Western conventions, such as the US National Institutes of Health NIH , have created units to research traditional medicines and practices. And TCM practitioners are increasingly looking for proof of efficacy in clinical trials.

They often speak of the need to modernize and standardize TCM. Chapter 26 is meant to be a standard reference that all practitioners can use to help diagnose disease and assess possible causes. On the basis of those observations, physicians can work out how to treat them. The patient, who would probably be diagnosed as diabetic by a Western doctor, would probably be prescribed acupuncture, various tonics and moxibustion — in which practitioners burn herbs near the skin of the patient.

TCM practitioners around the world are gearing up for Chapter 26, which is set to be implemented by WHO member states in Critics argue that there is no physiological evidence that qi or meridians exist, and scant evidence that TCM works. There have been just a handful of cases in which Chinese herbal treatments have proved effective in randomized controlled clinical trials. One notable product that has emerged from TCM is artemisinin. But scientists have spent millions of dollars on randomized trials of other TCM medicines and therapies with little success.

In one of the most comprehensive assessments, researchers at the University of Maryland school of medicine in Baltimore surveyed 70 systematic reviews measuring the effectiveness of traditional medicines, including acupuncture. None of those studies could reach a solid conclusion because the evidence was either too sparse or of poor quality 1.

Current Chinese President Xi Jinping has strongly supported TCM and, in , the powerful state council developed a national strategy that promised universal access to the practices by and a booming industry by That strategy includes supporting TCM tourism, which steers large numbers of people to clinics in China. Every year, tens of thousands of mostly Russian tourists flock to Hainan off the southern coast seeking relief through TCM.

The country also has global ambitions. By the end of , 17 centres had sprung up in countries such as the United Arab Emirates, Hungary, Kazakhstan and Malaysia.