Western medicine or Chinese medicine? China's TCM regulations spark debate

19 Jun 2020
society
Hayson Chenyu Wang, M.D.
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine
Translated by Candice Chan
TCM treatment is said to have played a role in the fight against Covid-19 in China. The Beijing authorities recently sought public views on a set of proposed regulations on traditional Chinese medicine (TCM), which includes articles that mention punishments for those who "defame and slander" TCM. A furore ensued as the public worried about the expansiveness of the proposed law. Oxford University visiting researcher Hayson Wang thinks hard about what lies at the nub of the issue and what TCM proponents must do to bring TCM practice into the mainstream.
Traditional Chinese medicine has its believers and detractors. (Hedy Khoo/SPH)

Recently, the Beijing Administration of Traditional Chinese Medicine released proposed regulations on traditional Chinese medicine (TCM) for public consultation.

Article 36 states that "no organisation or individual may engage in fraudulent or exaggerated publicity about TCM, use TCM's name to gain illegitimate advantages or harm the public interest, or defame or slander TCM via any means or behaviour", while Article 54 states that those who "defame and slander" TCM as set out in Article 36, by picking quarrels, causing trouble, and disrupting public order, would be subject to punishment by public security departments or even face criminal responsibility according to the law.

Firstly, what is "defamation" or "slander"? Does being of the opinion that TCM does not work count? What about believing that some medicines are toxic and will cause damage to the liver and kidneys? The definition is vague, but once one is found to be under suspicion of defamation or slander and possible unlawful or even criminal actions, the consequences are harsh.

...this tussle between Chinese and Western medicine involves an element of national ideology, especially in the context of swelling nationalism.

A TCM physician in Singapore preparing Chinese herbs, 5 May 2020. (Wang Hui Fen/SPH)

Legal technicalities aside, the regulations are aimed at promoting TCM, in particular, to counter doubts and contradictions from the Western medical sector. But for the administrative authorities to intervene in the tussle between Chinese and Western medicine - which should fall under the realm of academic discussion - is clearly and unjustifiably overstepping the boundaries.

Besides, this tussle between Chinese and Western medicine involves an element of national ideology, especially in the context of swelling nationalism. Coincidentally, infectious disease expert Professor Zhang Wenhong of Fudan University (who has become a popular online figure due to efforts against the coronavirus), encouraged people to consume more eggs and milk at breakfast and less noodles and porridge during a live broadcast, only to be criticised as "worshipping" the West - "Is a Western meal of eggs and milk better than traditional noodles and porridge?" critics asked.

If China wants to commit to scientific innovation and overtake its rivals, all the more it should raise the scientific literacy of its people and promote the independent spirit of science, while not bringing political factors into the mix.

Eggs and milk are rich in protein, while rice and noodles are mostly starch, with less protein. And protein is the main constituent for the synthesis of immunoglobulins for immunity and albumin for osmoregulation. Replenishment of protein is common scientific knowledge for maintaining health; there is no so-called conflict between Asian and Western cultures here.

Some comments have it that disparaging TCM is due to a mindset of buying into Western culture, and a betrayal of ethnic culture. But that is overstating the case. It is extremely inappropriate to bring differences in ideology into a scientific discussion. If China wants to commit to scientific innovation and overtake its rivals, all the more it should raise the scientific literacy of its people and promote the independent spirit of science, while not bringing political factors into the mix.

In fact, it is inaccurate to call it Chinese versus Western medicine; it is generally thought that it is more appropriate to call it traditional versus modern medicine.

A staff of the hospital at the Changchun University of Chinese Medicine preparing pills containing a traditional Chinese remedy against "dampness" in the body. (Zhang Yao/CNS)

These regulations also show the lack of confidence and oversensitivity of Chinese physicians in this tussle between Chinese and Western medicine. It has been said that to the Chinese, TCM is like a religion, and that wherever there is Chinese culture, there is room for TCM. In fact, it is inaccurate to call it Chinese versus Western medicine; it is generally thought that it is more appropriate to call it traditional versus modern medicine. Many places in the world have traditional medical systems similar to Chinese medicine, and the system of modern medicine as exemplified by evidence-based medicine cannot be simply classified as a prerogative of the West.

However, the traditional medicine community remains undecided as to whether or not to adopt the assessment model of modern medicine, as well as how to implement it.

Given the rapid development of modern medicine, traditional medicine does seem to be in a bit of an awkward position. Its academic system is trying to bring in modern scientific assessment criteria, but there are doubts from the fraternity as well as technical difficulties, resulting in a bottleneck.

Objectively, if traditional medicine is to modernise, it has to accept the assessment criteria of evidence-based medicine - objective, standard assessments of the safety and efficacy of classic medicines, prescriptions, and treatments would help advance the field, besides being the responsible thing to do to safeguard people's health. However, the traditional medicine community remains undecided as to whether or not to adopt the assessment model of modern medicine, as well as how to implement it.

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