Overview | The History of Chinese Medicine | What Is Traditional Chinese Medicine? | What Is Traditional Chinese Medicine Used for Today? | What Is the Scientific Evidence for Traditional Chinese Medicine? | Safety Issues
Traditional Chinese Medicine (TCM) is one of the most complex, highly developed traditional healing theories in the world, rivaled in its scope only by Ayurveda. Several parts comprise TCM: acupuncture, traditional Chinese herbal medicine, dietary interventions, exercise systems such as Tai Chi and Chi Gung, and theories about architecture and interior decoration known as Feng Shui. Its principles are essentially Taoist in nature and encompass (in principle) every aspect of human existence.
The principles of Chinese medicine developed within the larger sphere of the Taoist religion. Primitive acupuncture needles dating back to around 1000 BC have been discovered in archaeologic finds of the Shan dynasty in China.1 The theoretical framework underlying the practice of acupuncture was first set forth in the Inner Classic of Medicine, or Nei Jing, first published in 206 BC during the Han dynasty. Chinese herbal medicine, however, developed somewhat later. It received its first rudimentary theoretical foundations in the first or second century AD, but it was not until the 12th century that the deeper principles of Chinese medicine were fully applied to herbal treatment.2
Chinese medical theories involving diet follow along much the same lines as herbal theory; essentially, each food is an herb and has its own characteristic effects on the body. (A variation of this system known as macrobiotics has become famous.)
The relative importance of the two fields has waxed and waned over time. Herbology reached a state of high development in the 14th and 15th centuries; acupuncture then reached what might be called a golden age under the Ming dynasty in the late 16th and early 17th centuries. Subsequently, herbal medicine gained in importance; by the time acupuncture came back in vogue in 20th-century China, it had undergone a major transformation sometimes called the “herbalization of acupuncture.”
The martial arts for which China is famous also developed within the context of Taoism, and therefore follow principles consistent with Chinese medicine. The healing martial art known as Tai Chi is said to have been invented by the monk Chang San-Feng sometime in the Middle Ages; however, the exact dates (and even the existence of this monk) are disputed.
In China today, various aspects of TCM are used along with conventional Western medical treatment. Considerable attempts have been made to subject acupuncture, herbal therapy, and healing martial arts to scientific evaluation; however, most of the published Chinese studies on the subject fall far short of current scientific standards. (For example, they frequently lack a control group.)
In neighboring Japan, a variation of the traditional Chinese herbal system known as Kampo has become extremely popular, and many Kampo remedies have been approved for medical use by the Japanese Health Ministry. The scientific basis for these remedies remains inadequate, but several studies of moderately good quality have been reported.
Traditional Chinese medicine is an all-embracing system that, at least in theory, encompasses all aspects of human existence. Even a basic introduction to its principles far exceeds the scope of this article. Consider the following as nothing more than a taste of this vast medical system.
According to the principles of TCM, health exists when the body is balanced and its “energy” is flowing freely. The term “energy” refers to Qi, the life energy that is said to animate the body. The term “balance” refers to the relative factors of yin and yang, the classic Taoist opposing forces of the universe. Yin and yang find their expression in various subsidiary antagonists such as cold vs. heat, dampness vs. dryness, descending vs. ascending, at rest vs. active, and full vs. empty.
In an ideal state, yin and yang in all their forms are perfectly balanced in every part of the body. However, external or internal factors can upset this balance, which then leads to disease. Chinese medical diagnosis and treatment involves identifying the factors that are out of balance and attempting to bring them back into harmony.
Besides yin and yang, there are five elements or phases that can exist in harmony or disharmony. These are translated into English as wood, metal, water, earth, and fire. Each of these elements has characteristic properties and affects various organs, personality, and overall health in unique ways.
It is important to realize that diagnosis according to TCM differs greatly from Western diagnosis. For example, one patient with a migraine headache might be said to have “dryness in the liver and ascending Qi,” while another might be diagnosed with “exogenous wind-cold.” For this reason, there is no such thing as a TCM remedy for migraines per se; rather, treatment must be individualized to the imbalance determined by traditional theory.
In theory, TCM can address all possible physical, psychological, and spiritual problems. In the West, it is primarily used to treat long-term chronic conditions (eg, rheumatoid arthritis and menopausal symptoms), as well as some acute conditions that are not life threatening (such as menstrual pain and colds and flus). TCM is also widely used to promote wellness and prevent disease.
At present, there is no meaningful scientific evidence that the overarching principles of traditional Chinese medicine reflect true insights into health. There is some evidence, however, that certain TCM therapies may be helpful for specific conditions. Nonetheless, even here there are serious problems. Studies of traditional Chinese medicine performed in China generally fall far short of modern Western standards of scientific rigor.3,4 Furthermore, even studies performed according to the highest standards have some inherent problems due to the nature of the treatments themselves. For more information, see the articles on Acupuncture, Traditional Chinese Herbal Medicine, Qigong, and Tai Chi.
Acupuncture appears to be a relatively safe form of medicine as long as it is practiced appropriately. However, there are serious safety concerns regarding traditional Chinese herbal therapy. For more information see the individual articles.
1. Acupuncture: A Comprehensive Text. O’Connor J, Bensky D, trans. Seattle: Eastland Press;1985.
2. Bensky D, Barolet R. Chinese Herbal Medicines, Formulas, and Strategies. Seattle: Eastland Press;1990.
3. Wang G, Mao B, Xiong ZY, et al. The quality of reporting of randomized controlled trials of traditional Chinese medicine: a survey of 13 randomly selected journals from mainland China. Clin Ther. 2007;29:1456-1467.
4. Vickers A, Goyal N, Harland R, Rees R. Do certain countries produce only positive results? A systematic review of controlled trials. Control Clin Trials. 1998;19:159-166.
Last reviewed August 2013 by EBSCO CAM Review Board
Last Updated: 8/22/2013