My initial encounter with alternative medicine in general and oriental medicine in particular was the religious partaking of the Chrysanthemum flower tea as part of the popular contemporary culture that terms conventional as impure and organic as pure. My curiosity one day caused me to take a closer look on the writings on the packaging of my favorite tea where I found what amounted to a caution and an alarm. The alarm was to the effect that no herbal product should be partaken without reference to a medical practitioner and the caution was to the effect that all the information indicated in the package about the benefits of my Chrysanthemum flower tea had neither been perused nor approved by the FDA. This was the genesis of my curiosity towards alternative medicine that led to my brief love for Oriental medicine and finally to my current indifference thereto.
As an inquisitive youngster, I was quickly enchanted with Oriental medicine in general and Chinese medicine in particular. The Traditional Chinese Medicine (TCM) is surprisingly a vibrant billion dollar industry in the US complete with structured regulation and academic qualification and licensing (Cohn, 2010). In contemporary parlance, TCM can be defined as conjunction between 2,500 years of traditional medical practice research and modern medicine. Commonly used methods include dietary therapy, herbal medicine, the tui na (massage), the acupuncture and the Qigong (exercises).
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It is not possible to ignore its impact in today’s health practices in the United States. Just like me, over 50 million US citizens currently use one TCM dietary product or the other either for an ailment, condition or just general wellness thus creating a billion dollar industry, there is also the over 16,000 registered acupuncturists spread all over the US while thousands of gyms and health clubs have incorporated oriental exercises into their routines. This automatically led the scientist in me to investigate the effectiveness of TCM from a scientific perspective: whereas I was by now absolutely sure that something so successful cannot be wrong, in my mind only scientific proof counts.
The entire TCM philosophy is premised on the vital energy hypothesis, which states that the body has a vital energy, known as chi or qi that traverses the body through channels called meridians that connect directly to all the body parts and controls all the body functions (Misha & Doner, 2006). A harmonious flow of chi guarantees perfect health while any interruption thereof will create illness, disease or aliments. It is this pseudoscientific concept that has consistently given TCM more of a mystical rather than medical connotation and also placed it at a crossroads with mainstream religion as it creates the notion of alternative religious belief.
It therefore follows that the dietary regimes, the herbal medication, the exercises, and most importantly the acupuncture are meant to channel back the flow of the Chi, throughout the body, thus leading to healing, or rather resumption of health. This is based on the eight principles paired into four sets of two conflicting principles. These are: cold and heat, interior and exterior, deficiency and excess and finally Yang and Yin. These principles define the ailment, their symptoms and cures. Whereas it would be easy to dispel this as pure mythological, a juxtaposition between it and say the traditional Christian belief that all illnesses are caused by demons and are curable by exorcisms assisted me in giving more credit to these hypotheses.
Scientific research has however been carried out in many nations of the world with regard to the TCM claim but the overall consensus has always been that there is absolutely no scientific evidence or basis for the Chi claim. Despite this, the Chi theory has been accepted by many as absolute truth, a fact that is confirmed by the many users of TCM who are willing to pay fortunes for the same (Misha & Doner, 2006). The proponents of TCM have, however, found an easy explanation for this in that the research so conducted has not been capable of assessing the fundamentals of TCM including the effect of combinations of ingredients or complex interactive biological systems. This argument is premised on the fact that TCM rarely prescribes one definite cure; it is always a combination of two or more procedures. For instance, a patient may be told to combine herbs, with acupuncture, exercises, and massages then top it up with some longer time dietary supplements (Harriet & Korngold, 1992). Such a combination would be difficult to scientifically proof or disproof considering that research keeps on growing. As recently as 1950, proteins were believed to be the carriers of genetic material, a concept that would be scoffed at by a beginner today, who knows if the growth of research will not scientifically vindicate TCM in the near future.
As indicated earlier, the commonly used methods include dietary therapy, herbal medicine, massage, acupuncture and exercises. The most common and by far most controversial among them is the acupuncture. This is a term coined from the Latin terms for acus , meaning needle and puntura meaning to pierce and involves the insertion of thin needles in the body through very accurately defined positions called the acupuncture points mostly to relief pain. In advanced acupuncture, heat and laser light can also be directed to these specific points. Acupuncture is very common in the US especially in urban areas with thousands of licensed practitioners in the US. California is well known for acupuncture prevalence with almost a third of all registered acupuncturists practicing in that state (Suh, 2014).
Tui na (the massage) on the other hand is based on an effort by the practitioner to physically manipulate the flow of the chi through the needing, rolling, shaking, tapoting, pressing and/or rubbing specific joints termed as the eight gates of the eight principles indicated above. Qigong (the exercises) involves inter alia mediation, martial arts training, deep rhythmic breathing and creation of a calm meditative state of mind and is used both for healing or preventative purposes. Herbal medicine involves the use of concoctions made generally from herbal extracts, but also from animal and human extracts, for medicinal use.
Among the fundamental aspects of treatment is diagnosis so I next sought to find out how TCM practitioners in the US diagnosed patients. The general TCM diagnosis involves a five pronged approach. The first approach is the inspection which involves paying careful attention to the appearance of the patients face with particular emphasis on the tongue. The practitioner will consider the size, shape, tension, color and coating of the patients tongue as well as whether or not there are teeth marks on the outer edges of the said tongue. Next comes the listening part known as auscultation that involves listening to sounds relating to common human functions like breathing or the heartbeat. After listening comes the nasal tests which checks for the different odors emanating from the human body. The final physical test is referred to as palpitation and involves feeling the "A-shi" points, checking of the pulse and the outer abdominal captivity.
There is also the inquisitive phase based on a practice referred to as the seven enquiries. This involves many general and specific questions regarding the patient from wide ranging areas including the regularity of symptoms complained of and their severity, whether they recur or not, the presence or absence of other common symptoms such as chills, perspirations, fever, loss of appetite, thirst, defecation and urination issues, insomnia, general pain or discomfort and many others (Harriet & Korngold, 1992). It is from the totality of these five pronged tests that a practitioner will come up both with a diagnosis and a treatment regimen for the patient.
My curiosity with regard to TCM had its genesis from a statement that indicated the seeming lack or supervision with regard to alternative medicine in general and TCM in particular; I was, therefore, naturally interested in establishing the nature and level of superintendence with regard to TCM and where I found a well-organized system of checks and balances with regard to its practice in the US. From an academic perspective, TCM is available both as a graduate and post graduate course with over 50 masters programs available in the US.
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is a not profit organization that superintends the practice of TCM in most of the state in the US (Con & Ac, 2013). Its mandate includes establishing, assessing, promoting and supervising the standards of safety and competence in acupuncture and oriental medicine with a bias on public safety and benefit.
This organization issues a certification referred to as the Diplomate of Oriental Medicine; qualification for this requires both a Masters level degree in a recognized Oriental Medicine program which normally takes about three to four years of full time training as well as pass a NCCAOM certification examinations in Foundations of Oriental Medicine, Acupuncture with Point Location, Chinese Herbology, and Biomedicine under authorization by the Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM). The actual practice of TCM is also regulated by the NCCAOM (Braverman, Baker & Harris, 2009). Unfortunately, despite this rigorous tests and regulations, most states allow TCM procedures including acupuncture to also be conducted by conventional medical practitioners and chiropractors who have little or no formal training in these procedures.
As a scientist my understanding of TCM and other alternative medical procedures draws a very worrying picture on the common American overall approach to health and medicine. From the upshot of the foregoing, TCM is mostly popular for its placebo not curative effect yet it is now a multibillion dollar well regulated industry employing tens of thousands of professionals. I personally would rather go with the well tested and proven conventional medication with reference to TCM on those issues that are not fundamental to my overall health.
References
Braverman, C., Baker, C., & Harris, R. (2009). Acupuncture and Oriental Medicine (AOM) in the United States. American Acupuncturist , 4722-26
Cohn, S. (2010). Acupuncture, 1965-85: Birth of a New Organized Profession in the United States. American Acupuncturist, 5412-15.
Con, H. & Ac, L. (2013). Is TCM regulated? | taking charge of your health & wellbeing . Retrieved from <http://www.takingcharge.csh.umn.edu/explore-healing-practices/what-traditional-chinese-medicine/-tcm-regulated/>
Harriet, B. & Korngold, E. (1992). Between Heaven and Earth: A Guide to Chinese Medicine. New York: Ballantine Books.
Misha R. C. & Doner, K. (2006). The Chinese Way to Healing: Many Paths to Wholeness . Indiana: iUniverse publishers.
Reichstein, G. (1998). Wood Becomes Water. Chinese Medicine in Everyday Life. Tokyo: Kodansha International
Suh, T. I. (2014). Practice Management in Acupuncture and Oriental Medicine: A Cross-Sectional Survey of the Relationship between Acupuncture and Oriental Medicine Practice Management Courses and Financial Success. American Acupuncturist, 6722-44
