The Reality of
"Traditional Chinese" Medicine

Wallace Sampson, MD

This was originally posted on Medscape on 8/07/2006

Advocates of traditional Chinese medicine (TCM) say that TCM cannot be evaluated through "Western" judgment because TCM differs in tradition and orientation.[1] This mystery can be dispelled by examining TCM history objectively.

TCM developed in a tradition of an authoritarian culture. Independent thinking and argument were discouraged. A tradition of objective science did not develop.[2]

Diseases were not described. Symptoms and physical characteristics were related only to natural elements and the cosmos. Ideas conformed to those of the emperor and state. TCM contained no concept of physiology, biochemistry, organ function, heredity, or infectious disease. Tongue and pulse diagnoses were essentially random; therapies based on them were useless -- accepted on authority, not proved.[3]

What made TCM therapies appear effective? A collection of nonspecific psychological mechanisms, now known to be sources of error: misdirection, counterirritation (in the case of acupuncture and moxibustion), suggestion, and compliance demand. These observational errors and treater-subject interactions resulted in erroneous post hoc conclusions. Error was compounded by inability to identify error itself or to detect long-term effects. Conditioning and reinforcement, amplified by social pressures, created patient satisfaction and appearance of therapeutic success.[4]

New anthropological findings and China scholars' re-evaluation indicate that acupuncture descended from various informal techniques, not formalized until the 19th and 20th centuries, largely by Europeans[5,6] and in China by the cultural revolution. TCM is not highly regarded by modern Chinese physicians, as 85% or more of medicine there is scientific, and TCM is utilized through self-referral.[7]

TCM advocates in Western countries alternately propose that acupuncture effects have other scientific explanations, but unless they can prove that it has real effects and does not work through these nonspecific mechanisms that can apply to any method, their claims remain unverified and probably erroneous.

That's my opinion. I'm Dr. Wallace Sampson of the MedGenMed Editorial Board.

References

2. Qian Y. Science in China. Baltimore: Johns Hopkins University Press; 1985.

3. Imrie RH, Ramey DW, Buell PD, Ernst E. Veterinary acupuncture in historical scholarship: claims for the antiquity of acupuncture. Sci Rev Altern Med. 2001;5:133-139.

4. Beyerstein B. Social and judgmental biases that make inert treatments seem to work. Sci Rev Altern Med. 1999;1:20-33.

5. Imrie R, Ramey D, Buell PD. Veterinary acupuncture in historical perspective. Sci Rev Altern Med. 2004-5;8:61-68.

6. Unschuld P. Medicine in China. A History of Ideas. Berkeley, Calif: University of California Press; 1985:57-58.

7. Sampson W, Beyerstein B. Report of the CSICOP investigation of medicine in China. Skeptical Inquirer. 1998;20.