Chinese medicine in dilemma

In a consulting room in the Jinan Chinese Medicine Hospital, east Shandong Province, a brown-mustached caucasian in his white uniform is taking the pulse of a patient.

The doctor, Peter Knithof, is a traditional Chinese medicine (TCM) student from the Netherlands. He has been studying in China for five years. Along with him is Lee Jae Hak from the Republic of Korea.

The pair said Chinese medicine has become quite popular in both of their countries, which is part of the reason why they decided to come to study Chinese medicine.

Lee suffered from an illness during his childhood. After using Chinese medicine he got much stronger. "My family and I have seen the wonders of Chinese medicine," Lee said.

After four years' language and professional training at a Chinese university, they now speak fluent Chinese and are taking part in internship at the Jinan hospital. To them, studying Chinese medicine is also an important aspect of understanding the traditional Chinese culture.

Like Taichi and Shaolin Kungfu, the doctrines of Chinese medicine are rooted in the ancient Chinese culture. While Western medicine conducts research based on anatomical structures, TCM perceives health as a harmonious interaction of the body and the outside world.

TCM is not supported by evidence-based modern medicine. It, nonetheless, traces symptoms by checking the pulse and inspecting the tongue and meridians, which the Western world views as a mysterious concept and has long been reluctant to accept.

Chen Qiguang, who leads a TCM research group in the Chinese Academy of Social Sciences, said that the Chinese and the West use distinct systems and theories regarding medication, which is why non-Chinese have difficulty in trusting in TCM.

"In Western medicine, the disease is treated as an enemy," Chen said, "the best way to cure cancer is to kill all tumor cells."

"In Chinese medicine, we believe that if the body reaches an internal balance, patients will still be able to live a healthy life even with some cancer cells inside the body," Chen said.

Chen said many in the United States and Europe are used to seeing things in an absolute "scientific" way, which usually means data and evidence.

It is much easier for Western people to accept techniques such as acupuncture, Guasha and massage, because process of the treatment could be seen and immediate effects be felt.

Knithof said acupuncture is the most popular form of TCM in his home country. "In the Netherlands, many patients recognize the effect of acupuncture and Tuina," he said. "But as for herbal medicine, many think it not medicine, but a kind of healthcare product."

Even though TCM has showed great effect on many diseases, many still question its effectiveness on major diseases as TCM practitioners rarely conduct operations. Chen believed that TCM has led to positive results in critical illnesses such as SARS, AIDS and cancers, particularly in treatment of children.

Six-year-old Liu Tao has been receiving daily rehabilitation under the instruction of TCM therapists for a year. Liu, who is difficult to stand unaided a year ago, is now able to walk slowly.

The Liangzhou Hospital in northwest Gansu Province has implemented TCM on children with cerebral palsy for three years. More than 100 children have benefited from the treatment, with the youngest patient being five months old. Seven children were almost cured.

Xu Shuhui, a therapist from the hospital, said the best advantage of TCM is that it causes little pain. "Children accept the treatment very well. We are quite satisfied with the results so far."

Another benefit of TCM is that the treatment is much cheaper.

Doctors of Western medicine rely on advanced equipment to conduct diagnosis, the cost of which is often high. TCM doctors carry out treatment anytime anywhere, and use a kaleidoscope of materials from nature, which greatly reduces the cost of treatment.

TCM now has become better recognized in many countries, including Australia and Brazil.

In Australia, five universities and 10 colleges, including Sydney University and Sydney University of Technology, have launched TCM programs, many of which have been certified by Australian education regulators.

Nevertheless, development of TCM still faces challenges.

Earlier this year, the Australian Health Practitioner Regulation Agency announced as of July 1, acupuncturists and Chinese herbal medicine practitioners must be registered under the national registration and accreditation scheme with the Chinese Medicine Board of Australia.

Under the regulation, many practitioners would suspend their businesses until they pass the registration.

Acquiring a medical license is difficult not only overseas, but also in China.

Chen said China has adopted Western standards to regulate its medical system. It is not convenient for TCM because under the regulation, all practitioners are requested to pass a license exam, which includes exams on English and Western medical theories, which are major obstacles to rural practitioners.

Official data showed in 2010, there were about 294,000 Chinese medicine practitioners in China, while Western medicine practitioners were almost eight times more at 2.32 million.

Lack of sufficient education is the main reason why the number of TCM practitioners declined in recent years.

"College students majoring in TCM spend one third of the time learning English and general courses, another one third learning Western medicine. This means they only have about one year of studying Chinese medicine. It is almost impossible for them to become skilled at campus," Chen said.

Doctor Zhang Wei of the Jinan hospital said that modern education has broken the traditional apprenticeship of TCM. This brings up another problem -- many TCM practitioners are now not able to recognize some rare herbs.

In modern TCM education, acupuncture, Tuina, herbs and TCM diagnosis are divided into different disciplines for the traditional apprenticeship system, which requests a TCM doctor to manage all the skills through practice.

Experts also worry about deteriorating quality of herbs in the Chinese market.

The Anhui provincial drug authorities recently investigated 12 herbal production companies in suspect of using chemical dyes in production of herbal medicine.

Ginseng, Goqi and Shouwu were all once very common in the market. In recent years, however, many customers complained that bogus TCM materials made it hard to buy genuine wild herbs.

Luo Shiwen, former inspector for the State Food and Drug Administration (SFDA), said that modern methods of mass breeding have greatly reduced potency of herbal medicine.

Chen said that a significant proportion of the best herbs are exported, which help push up the price of domestic herbs.

In response to the problem, earlier this month, SFDA initiated a national crackdown on substandard or fake materials used in TCM production.

Knithof, who considers whether to stay in China after graduation, is optimistic about a future career back in the Netherlands as seeing more patients have realized the effectiveness of TCM.