For some, the inclusion of Chinese herbs in the World Health Organization’s (WHO) latest (11th) version of its list, known as the International Statistical Classification of Diseases and Related Health Problems (ICD), brings celebration.
For others it brings disdain, contempt, and concern.
You might guess which side I’m on, but here are a few arguments the critics are giving.
Believing in the effectiveness of TCM is like believing in unicorns
Some Traditional Chinese Medicine (TCM critics argue that the WHO’s inclusion of TCM treatments gives credence to something that is nothing more than a “belief system” and “magical thinking” (as stated in this Forbes article). They state that there is insufficient evidence to support the effectiveness of TCM’s treatments. In that article, Salzberg states that alternative, holistic, integrative, and functional medicine are “all just marketing terms, with no scientific meaning. They merely serve to disguise sloppy, unscientific thinking at best, and in a less charitable interpretation, outright fraud.”
I get it, TCM language and entire way of describing how it diagnoses and treats patients is entirely different from the way the Western world does so. I spent the first semester of TCM school in confusion and argument with myself–“But I learned this not that in physiology class.” I had to temporarily mentally pack up and put aside my western medicine knowledge in my brain, allowing for the new ideas to enter and be processed. Only later was I able to unpack and combine those very different approaches to health.
Traditional Chinese Medicine is based on centuries of observation, trial, and error. It is a compilation of scholarly studies and clinical trials. Remember: this is the basis for research.
The whole reason why I was drawn to TCM was that many of its foundational principles just made sense to me. Things like:
- We are designed to heal, and given the right support and guidance, we can do just that.
- We are more than our parts.
- We are each individual, so it’s better to focus on the person, not the disease (And, you can treat both).
- We cannot separate body, mind, and spirit. They are inter-related.
- Our needs change with the season, our daily activities, our stress levels, our age, and so forth.
- We are part of nature and thus are affected by our environment.
- We can observe nature for clues about how to live healthy.
- Each of us can take control of our own health, making choices about the food we eat, the activities we take on, how we listen to the cues our bodies give us, how we manage stress, and what we spend our mental energy on.
- Nature has provided us with the tools, including herbs and foods, to support our healing.
So, does TCM have scientific support?
It’s very hard to study TCM with today’s gold standard research methods. The gold standard would be that there is a large group of subjects, randomly selected and divided into at least two groups–the group(s) to receive the treatment(s) being studied and a placebo group who thinks they are receiving treatment, but are not. Additionally, to try to avoid biases, the study should be double-blinded. That means that neither the person doing the study nor the person who’s the subject being tested on know if the real treatment or a fake (“sham” or “placebo”) treatment is being applied.
But how do you double blind an acupuncture study?
Some studies use retractable needles (like the fake knife that pulls up into the handle when a person is “stabbed”); some simply apply pressure to the skin without the needle; and some put the needle in a point not defined as an official acupuncture point. For the first two methods, if you’ve received acupuncture in the past, you’re likely to know during the procedure that you’re getting the fake treatment. For for the last method, well…there are a lot of points and some of the points are not the standard points officially documented. There are “extraordinary” and “ashi” (i.e. yes, that spot is tender) points, as well as points that are under different models of study and practice. So, a “non-point” might unintentionally be an effective point.
Furthermore, research likes to study one variable at a time. That means, for example, that you might want to study the effectiveness of one new drug for the treatment of one disease. Your variable could be testing that drug against a placebo. Everyone in the test group gets the drug and everyone else gets the placebo and how many people improve from that one disease is evaluated. If you want to get fancier, you could have a few groups, each with a different dose of the drug to compare which dose works best.
The challenge is that for both herbs and acupuncture, it’s tough to test the effectiveness of a TCM treatment on one disease or symptom. In TCM, each person is considered as a unique individual, so what treatment works for one person may not work for another, though they share the same disease. The key to TCM–where the TCM practitioner must become skilled–is to best understand the patient, their constitution, current issues, past issues, strengths, and weaknesses.
TCM addresses treatment as “different diseases, same treatment; same disease, different treatments.”
Regardless of these challenges, there is supportive research for TCM treatments, and this point is often blurred over by those arguing against it. Check out some examples of TCM research on my site here: Research on TCM. And for something funny and poignant, check out this Getting High on TCM.
Supporting TCM will contribute to the destruction of ecosystems
This is another argument given by TCM critics. They show ghastly images of rhinos with their horns cut off and say, “See?”
They state that endorsing Chinese herbs is an endorsement of the use of rhino horns, tiger bones, and pangolins, further risking the survival of these endangered animals. The thing is, rhino horns do NOT make you more virile and tiger bones do NOT make you stronger. Pangolin scales, well, I had to actually refresh my memory and look them up to see that they have been used to treat skin conditions. I’ve never used any of these herbs, and the good news is that these products are illegal in most countries–and rightfully so!
I don’t even know if the WHO specifically lists these particular herbs (couldn’t find evidence of that in my online search).
The key to preventing people from using these inhumane and harmful products is to get people to BE less inhumane and uncaring. And, to continue to keep them illegal to trade, sell, and transport. When, last October, China tried to re-legalize the trade of rhino horn and tiger bone, there was such a public outcry against it, that they put that on hold.
Practitioners need to seek out more environmentally-friendly and ethical options, and guess, what? There are many!
Supporting TCM treatments doesn’t mean that you support all aspects of it. Western medicine used to do a whole lot of bloodletting to treat everything from infection to seizures, too often causing the more rapid death of the patient. It also used trepanation (drilling holes into the skull) to treat mental illness and migraines; gave mercury, cocaine, or morphine to teething babies; thought that having a uterus made women crazy; and had travelling doctors performing frontal lobotomies (using something like an ice-pick jabbed into the brain via the eye socket). And, more recently, greatly over-prescribed opioid medications, causing an addiction epidemic from which we have yet to recover.
I’m not anti-conventional medicine. In fact, I recommend my patients talk to their MDs and get necessary blood tests, imaging, surgeries, and treatments as appropriate. I do the same for myself.
Saying that supporting TCM will cause more people to use endangered animal products and destroy our environment is ridiculous. We allow for the advertisement of cars and new clothing and all kinds of consumables that, in our overuse, are contributing to our environmental disasters. We need to be better informed and more responsible, and that is readily doable within the natural health realm.
TCM herbs are dangerous and will poison you
Here’s a good question I’ve been asked by patients: “How can I trust the quality of the herbs you provide?” Some people apologize to me as they ask this. I tell them not to apologize for this and instead thank them.
Scientific American published an article stating, “In China, traditional medicines are unregulated, and they frequently make people sick rather than curing them.” They didn’t state a clear reference to that, but I believe them. Sort of. I really question the use of the word “frequently.” I think they are stretching quite a bit there.
Regardless, China has very different standards than North America. That’s why I don’t recommend or sell the cheap patent herbal formulas that come out of China. The suppliers I (and many of my colleagues) use have third party testing done to ensure quality and safety.
While we’re considering safety, I think it’s worth noting some stats from iatrogenic (physician-caused) deaths. A 2016 study by the leading research university John Hopkins found medical errors to be the third-leading (after heart disease and cancer) cause of death with more than 250,000 people dying of medical mistakes every year in the U.S. Other reports take the numbers as high as 440,000.
But we don’t throw the baby out with the bath water. We still need conventional medicine.
Let’s continue to improve
Rather than continue to attack each other, we should be working together and improving our medicines, diagnoses, assessments, treatments, and recommendations.
Listing Chinese herbs as part of the WHO’s repertoire of available treatments is an acknowledgement of how its an important part of the health therapies used by a huge global population. It helps the WHO to track the use and may provide incentive for more research to be done so that TCM can continue to evolve and improve.
As stated by Dr. Margaret Chan, the previous Director-General of the WHO, today’s world of growing technological dependence has lead to a very expensive medical world. We need medical options like TCM, as it “stresses prevention as well as cure, offers integrated services that address the multiple determinants of health, and asks people to take more responsibility for their own health.”
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