The integration of Chinese Medicine into mainstream healthcare can only be achieved if the philosophy and practice of biomedicine are accepted by all practitioners alike. Western Medicine (WM) and Chinese Medicine (CM) are the two most extensively used medical systems throughout the world today, the two systems were integrated successfully throughout China in 1949 when Chairman Mao developed the Chinese health care system into one more adequate for the population of China.
Chairman Mao is quoted to have said ‘Although we should have an all-round and correct understanding of Chinese medicine, Chinese medicine also has to transform itself. We must accept this slice of our old heritage critically. To look down upon Chinese medicine is not correct. To claim that everything about Chinese medicine is good, or too good, this is also not correct. Chinese and Western medicines must unite. ’ (Taylor, 2004) To date, across China, 95% of WM hospitals have a CM department (Robinson, 2006, p132).
In order to discuss the proposition that the integration of CM into mainstream healthcare can only be achieved if the philosophy and practice of biomedicine are accepted by all practitioners, it will be necessary to review what CM is how it was introduced to the United Kingdom (UK) and to define what the philosophies and practices of CM and WM are. CM in the UK is thought of as a complementary medicine which is defined by Ernst (1995) in a letter to the British Journal of General Practice as ‘... iagnosis, treatment and/or prevention which complements mainstream medicine by contributing to a common whole, by satisfying a demand not met by orthodoxy or by diversifying the conceptual frameworks of medicine’ (Ernst, 1995, p506) CM was introduced to the UK with the arrival of thousands of Chinese immigrants during the 60s and 70s but grew in popularity in 1971 when the international media reported that President Nixon, who was visiting China, received acupuncture following an emergency appendectomy.
After receiving acupuncture for post-operative pain Nixon was so awed by the results that he wrote about his travelling companion James Reston, a New York Times journalist wrote about the experience and piqued the interest of the public who began to investigate this ‘new’ healing art. (Presnsky, 1971) However, CM is nothing new and is steeped in history which can be traced back almost to three thousand years through the publication of the ‘Huang Di Ni Jing’ which translates to the ‘Yellow Emperors Medicine Classic’. It is comprised of two volumes containing the foundation of CM and the way it is used in diagnosis and treatment.
The Yellow Emperors volumes are comparable to Hippocrates’s ‘Corpus’, a collection of around sixty books, which were published circa the same era and are still the standard text books for medical students studying WM today. The philosophy and practice of CM is almost at the opposite end of the spectrum when compared to WM, with CM using logical diagnosis through clinical observation of the patient and emphasizing the part the body must play in treatment by studying the individual as a whole and CM works to maintain good health through balancing the body as one entity rather than a collection of internal organs, muscles and bones.
WM tends to use a reductive and analytical method of treatment and is standardized meaning that it will isolate a problem then treat the symptoms of the problem through the use of medicines and pharmacology which has a scientific evidence base. This form of treatment will be diagnosed for every patient displaying similar symptoms regardless of other factors which a CM practitioner may see as significant.
CM consists of several therapies such as Moxbisution, the use of a burning herb known as common mugwort to act as a counterirritant and to heat areas of the skin, acupuncture, Chinese herbs and nutrition, a system of massage across the entire body which includes the application of pressure to particular points of the body known as tui na, a martial art form known as tai chi and meditative breathing exercises called Qi gong. CM is slowly making headway into mainstream healthcare as more practitioners of WM begin to recognize the therapeutic effects and benefits of treatments such as acupuncture.
Already there are several diseases, symptoms or conditions which have been proven to be treatable through the use of acupuncture by controlled clinical trials which the World Health Organization (WHO) have advocated (WHO, 2003) such as the adverse reactions to radiotherapy or chemotherapy. However for CM to gain greater recognition and be seen as having greater efficacy then research is required but this is a costly undertaking and CM does not have the financial backing of large pharmaceutical companies who raise a great deal of revenue and who have the autonomy to fund their own research.
From a pharmaceutical point of view, if there is money to be made from a product then it will be researched, if there is not, like the treatment offered by CM then it is overlooked such as the research carried out in China during the outbreak of the Severe Acute Respiratory Syndrome (SARS) virus of 2004 where Chinese herbs were combined with WM to gauge their efficacy. (Zhang, 2004) The results of which were positive however due to SARS being a new strain of virus and being a sudden outbreak disease a longer period of follow up would be required to glean greater results.
Some conditions which people seek medical help for from WM such as rheumatoid arthritis or depression are usually treated with drugs such as steroids or anti-depressants, which and these may have quite detrimental side effects. If CM was available as an alternative, via the National Health Service (NHS) or a referral from a General Practitioner (GP), then any side effects derived from the use of drugs could be alleviated.
The underlying problem is that WM’s use of pharmaceuticals is accepted as the norm throughout society and even though it is common knowledge that the majority of these drugs are known to have side effects they are often overlooked by the patient as just being acceptable because, arguably, in WM the purveyors of drugs (GPs, hospitals and other medical figures of authority) are trusted as the only health systems that work. That is not to say that the pharmaceuticals available should be disregarded as a treatment, many great things have come from WM research, including antibiotics and immunisations.
However it is fair to say that CM is not without its problems. There are risks, however slight, of allergic reaction when taking prescribed herbs and some of the herbs used do have some toxicity to them, although when prescribed by an fully trained and experienced practitioner those risks are minimized. This problem is addressed though in a study by Jia (Jia, 2010) submitted to the WHO established Commission on Intellectual Property Rights, Innovation and Public Health (CIPIH) where it is suggested that with proper training along with standardizing clinical use of herbs there would be a reduction and therefore keep risk to a minimum.
It was also suggested that regulations be put into practice and in 2011 the Health Professions Council was granted the power to regulate herbal medicine. There is further evidence fifteen years ago that integration of CM had begun to integrate into mainstream healthcare with articles such as that of Woollam and Jackson whose 1996 survey of acupuncture practice in chronic pain clinics in the UK shows that, of the 172 clinics surveys 144 had acupuncture as a treatment available. Woollam & Jackson, 1998, p593) The British Medical Association carried out a survey and found that 79% of the GPs surveyed would like to see acupuncture available on the NHS, (BMA, 2000) however the NHS is already stretched financially and offering another treatment would mean employing trained practitioners into health care system which is making redundancies across the board.
As research continues into which different conditions can be treated with CM, the WHO treatment list will grow and more treatments will be made available through the NHS. With the acceptance of the philosophies of CM and WM by all medical practitioners a comprehensive healthcare system can be achieved and with the integration of CM into mainstream healthcare any uniformed scepticism would be alleviated from the public perception.
From the WHO outlook of the potential values of CM and the views of the GPs in the BMA report it appears that CM is gradually finding its place into mainstream healthcare however there is still a long way to go and until CM is seen as an entity in itself rather than be grouped with other alternative medicines systems which do not have the same historical efficacy then the integration of CM may always remain elusive.