The Evolution of Chinese Medicine over the Last 150 Years
While Chinese medicine began 2,400 years ago, the acupuncture and herbology taught in the People's Republic of China today is dramatically different from its traditional practice. The last 150 years have had a greater impact on its evolution than at any other time in its history. To truly understand the state of Chinese medicine today, one must begin in the mid 1800's. China was under the rule of a corrupt and weak Qing Dynasty; foreign powers were carving 'spheres of influence', essentially occupying its sovereign territory; and the Opium War ensured an epidemic of addiction among its population. Chinese intelligentsia began to face the reality that its culture was neither as strong nor as powerful as that of the foreign countries they had considered as uncouth barbarians. They came to believe that China had been focused on the achievements of its past, whereas foreign powers were focusing on developing the new, the modern. They saw that China's closed borders policy to the outside world had kept it from the inventions and discoveries of the times and believed China had to modernize in order to remain a sovereign power of influence. This movement grew until eventually the Imperial court was overthrown and the Republic of China was founded under Sun Zhongshan (Sun Yatsun) and the Nationalist Party in 1911.
The Nationalist Distrust of Its Own Traditional Medicine
With the desire to modernize also came a distrust of China's traditional knowledge. The backlash against traditional customs was far reaching, outlawing everything from wearing the 'cue' of long hair to its own medicine. In 1928, the Nationalist government declared the practice of Chinese medicine illegal, believing it superstitious and backward compared to the growing influence of penicillin based western medicine. This was not without some justification, as during those times of war, turmoil and hunger, a large amount of charlatan practitioners similar to snake-oil salesmen in America's Wild West were at work throughout the cities and countryside. This was coupled with the introduction of penicillin from the west, a miracle cure and proof of the superiority of all things modern at the time. While unsuccessful at completely outlawing Chinese medicine, it was forbidden in hospitals and government organized health facilities. Now existing outside of the official medical system and lacking regulation, an even larger number of charlatans outshadowed the authentic lineages of Chinese medicine being passed on in teacher-disciple relationships.
What then followed was an incredibly violent and difficult period of history for China. A Japanese invasion and subsequent occupation lead to great sympathy for the underground Communist movement. As Communism began to gather momentum, a civil war was unleashed on an already battered country. When the Communists emerged victorious and founded the People's Republic of China in 1949, traditional knowledge and teaching methods had already undergone almost 100 years of hardship.
Traditional Chinese Medicine in the Early Years of Communism
In the first years of the People's Republic of China, the Ministry of Health simply continued the policies that existed under the Nationalist government towards Chinese medicine. However, as the depth of poverty and illness left from decades of war became apparent, the government encouraged any type of medicine, Chinese or Western, to help the masses. This lead to the creation of government sanctioned institutes for the study of Chinese medicine and the establishment of Chinese medical hospitals. For a brief time, old doctors of great lineages found themselves respected by the government and teaching in schools. However this support of traditional medicine was set against the backdrop of the catastrophic famines that followed Chairman Mao's Great Leap Forward. By the end of 1961, efforts began to remove him from power.
The Cultural Revolution and Chinese Medicine
In order to retain control, Mao launched the Cultural Revolution (1966-76) and purged those in the government against him. The propaganda of the revolution was all things of China's past were the source of its current difficulties, and the old practitioners who were just recently brought into the educational system found themselves labeled as counter-revolutionaries and enemies of the state. They were removed from administrative and teaching positions within Chinese medical schools and purged from the governing bodies within the Ministries of Health and Education. Many of them were jailed or died during that time. Chinese medical institutions quickly shifted from traditional theories to current scientific models of Western biomedicine in order to weather Communism's anti-traditionalist campaigns.The Divergence of Traditional and Contemporary Chinese Medicine
After the end of the Cultural Revolution in 1976, China spent the next three years rebuilding an educational and medical infrastructure. This included the reopening of Chinese medical universities. However, in a bid to seem modern, the only the aspects of acupuncture's traditional theories which matched with western anatomical and neurological models of the body were stressed in the teaching curriculum. Studies into the active single chemical ingredients of herbs became more important than thousands of years of experience and knowledge combining them together as a whole. Marginalized, the traditional practitioners were replaced by a younger generation of doctors convinced that like the New China growing around them, a new biomedical research based medicine would be far superior to its traditional origins. Viewed as unscientific in their methodology, the last generation of doctors were seen as interesting sources of empirical techniques instead of repositories of traditional theory. Tragically, traditional theories that did not fit the new model or did not meet with Communist approval were removed from the textbooks and curriculum, their clinical application and understanding at risk of being lost forever.The Chinese
Government's Efforts to Document Traditional Medicine
By 1979, some members within the government were aware of the schism existing in the practice of Chinese medicine. Just before retiring, the Director of the Chinese Medicine Department in the Ministry of Health, Lu Binkui, established a National Association for Chinese Medicine and launched a project to record elder doctors throughout the country. Unfortunately, in spite of his efforts, the persons in the positions of authority to implement the project were the very doctors convinced of the superiority of a modern based medicine. As a result, their documentation efforts were so skewed in this manner that traditional practitioners found themselves being patronized by young science-based researchers. Angered by this treatment and still living in fear from the Cultural Revolution, the practitioners offered them little real information. In turn, the young researchers took this as proof that traditional medicine had little to offer the theoretical foundation of modern Chinese medicine.By the late 1980’s, the disparity between the clinical efficacy of the few traditional practitioners still in practice and that of the Chinese-Western combined medical practitioners had become too obvious to ignore. In 1990, the government launched a teacher-disciple training program in an effort to recreate a traditional training environment. In a country of over a billion people, the government only found 500 traditional doctors still able to take on and teach disciples. Each of the doctors was assigned two students who were to learn their theories and strategies, carrying on their knowledge after they passed away. Stringent criteria were drawn up for the students: they had to be in practice for over 15 years; they had to have a position of at least deputy-chief doctor; and they were not allowed to have a western medical background so as to influence their thinking of the traditional medical paradigm. The old doctors were very moved and excited, but soon found that the implementation of the project was ineffective. Finding suitable students was very hard, and those chosen were often too busy to really spend time with their mentors. Having already been in practice for such a long period of time under the current system, they often had their own thoughts on treatment methodology too firmly ingrained to absorb their teachers' thinking. In turn, the old doctors found that these students were seeking more effective techniques to apply immediately rather than applying themselves to the discipline of learning traditional perspectives on treatment that requires time, attention and diligence.
The Challenges Facing Traditional Medicine in China's Emerging Market
Today, China is the world's fastest growing consumer market. Boasting population of over a billion people, the battle for their new-found income is growing at an incredible rate. 'Traditional' medicine has become a highly profitable and often fraudulent market as the Chinese seek answers to lifestyle issues such as obesity, impotence, high blood pressure, diabetes and beauty enhancement. Doctors claim miracle treatments for everything from cancer to hair loss to breast enlargement, Chinese medicine 'cure-all' pills have flooded the market, and clinics touting specialists are appearing everywhere. While more legitimate, even the state run Chinese medical hospitals have established upscale treatment facilities as income generators in the face of dwindling government subsidies. The more reputable clinics do their best to hire the last of the elder doctors still in practice, but their focus is on using them is financial, not altruistic. Suspicious of the motives of students and institutions who approach them in these money focused times, the doctors are wary of trying to pass on their experience during their last years.
The Association for Traditional Studies in China
With almost 15 years of expertise preserving, documenting and disseminating the knowledge of traditional practitioners in China, ATS has embarked on a new initiative to protect the Pre Communist practice of acupuncture and herbology from extinction. Spurred by the recent passing of several of the traditional practitioners it had actively worked with since its inception, ATS is concentrating its preservation efforts in China over the next 5 years. Within the next 5 to 10 years, it is feared that most of this last generation who were born and educated prior to 1949 will have passed away. Those still alive will most likely be too old or infirm to actively record their clinical skills. As a part of this new endeavor, ATS is expanding the visibility of this work so that the voices of this last generation can help shape the Western understanding of traditional medicine as it becomes accepted into the current medical paradigm of integrative medicine.