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Chinese Medicine in Crisis

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Chinese Medicine in Crisis JOURNAL OF CHINESE MEDICINE NUMBER 61 OCTOBER 1999 SCIENCE, POLITICS, AND THE MAKING OF “TCM” CHINESE MEDICINE IN CRISIS by Heiner Fruehauf This article1 is based on the conviction that the traditional that the traditional science of Chinese medicine has over art of Oriental medicine is dying - both in mainland China, allopathic medicine and its various offshoots. home of the mother trunk of the field, and, consequently Mine is thus an urgent call for a re-evaluation of the overseas where branches of the tree are trying to grow. It direction and the fundamental convictions that we set for may be an anachronistic piece, written ourselves as individual Oriental medicine practitioners. at a time when TCM administrators Otherwise we may become thor- around the world are celebrating “In recent years, the unique characteristics oughly entrapped in the spiritless major advances in the field, such as of Chinese medicine, its advantages over mechanisms of state agencies, insur- increasing numbers of students, Western medicine, and its standards of ance companies, and most of all, our practitioners, patients, colleges, modern mind that has been condi- academic excellence have not been universities and hospitals, which all tioned to fancy the unambiguous, developed according to the wishes of the appear to reflect a booming state of standardised, packaged approach. It Oriental medicine. But if we truly people, but have rather been tossed into a is admittedly an opinionated warn- respect our tradition as a living state of severe crisis and chaotic actions. ing, but a sincere and, I believe, rea- organism and listen intently to the Underneath the bright and cheap glitter at sonably informed one. From both my deeper layers of its pulse, it becomes the surface, the essence and the own perspective and that of my most evident that the original vitality of the characteristics of Chinese medicine are respected teachers in China (includ- system is expiring, although its true being metamorphosed and annihilated at ing high ranking administrators condition may be obscured by a within the TCM system), modern a most perturbing rate. The primary steroidal glow on the surface. TCM in East and West is about to expression of this crisis is the Westernisation The following is primarily an reach the “fall height” of the classical epitomised narrative of the of all guiding principles and methodologies tragedy - featuring the vainglorious development of “TCM,” the medical of Chinese medicine.” protagonist luxuriating at lofty system that has monopolised the Lü Bingkui, former director of the PRC's Ministry of heights (i.e. mainstream acceptance practice of Oriental medicine in TCM Administration, July 1991 and doctoral level ratification), while mainland China, and that has come to blindly cutting into the life supply serve as the main mould for the budding profession of line without having a clue of the consequences. Oriental medicine around the globe. It exposes a system that has been conditioned by a distinctly political agenda, First Impact: The Modernisation of China During and reveals its logo “TCM” (Traditional Chinese Medicine) the Late 19th and Early 20th Century as a grave misnomer - designating a medicine that is not at The end of dynastic China marked a peak season for Chinese all aiming to preserve the traditional characteristics of medicine. Although nearly every other aspect of society Chinese medicine, but on the contrary, to expurgate, reform, was in a state of collapse and disarray by the middle of the and control the classical and folkloric texture of the 19th century, the culture of traditional medicine was alive traditional record in the name of progress. Between the with the multihued color and texture of a 2,500 year-old art. lines of this argument resides the warning that the There was the stimulating discourse between the newly progressive removal of the unique foundations of Chinese founded fever school and the school of the neo-classicists, medicine is far more than just a philosophical issue. It there were numerous scholar physicians publishing affects the heart of our medicine itself, namely the nature of influential discourses, and there was the arcane realm of the clinical encounter and the quality and the results of esoteric discipleship, alchemical experimentation, and the therapy. It greatly diminishes, moreover, the unique edge kaleidoscopic facets of folk wisdom that have always 1 JOURNAL OF CHINESE MEDICINE NUMBER 61 OCTOBER 1999 characterised the sensuous heart of the profession. this personal bias into the legislative arena and presented The advent of Western medicine presented the tradi- the radical proposal “A Case for the Abolishment of Old tional healing tradition with its first major challenge from Medicine to Thoroughly Eliminate Public Health Obsta- which it never completely recovered. It lost its rank as the cles” (feizhi jiuyi yi saochu yishi weisheng zhi zhangai an)2. one and only “medicine” (yixue) and became “Chinese Authored by Yu Ai and Wang Qizhang, the proposition medicine” (zhongyi), defined in contrast to “Western medi- aggressively infers that “the theories of yin and yang, the cine” (xiyi). Immediately, however, there developed an five elemental phases, the six atmospheric influences, the early brand of progressive physicians who did not lament zang-fu systems, and the acupuncture channels are all this situation, but attempted to integrate some of the para- illusions that have no basis in reality” and warns that “old phernalia of modern medicine into the traditional system. medicine is still conning the people with its charlatan, These pioneers are now collectively referred to as the Chi- shamanic, and geomancing ways”3. The proposal, contain- nese-Western Integration School (zhong xi huitong pai). ing three major clauses (severely restrict the practice of Main representatives are Wang Qingren (1768-1831), Tang Chinese medicine; prohibit Chinese medicine advertise- Zonghai (1851-1908), Zhang Xichun (1860-1933), and Zhang ments; bar the establishment of Chinese medicine schools), Shouyi (1873-1934). It is important to note that these initial passed the first legislative session of the Central Ministry of “integrators,” often cited by TCM administrators as early Public Health on February 26, 19294. Although the propo- visionaries of their own system of integrated medicine, sition was not implemented due to thousands of protesting were not proponents of the hierarchical superiority of West- doctors and patients who took their passionate disapproval ern medicine, but rather tried to embody the traditional to the streets, the production of anti-traditional sentiment in ideal of the broadly educated master physician. It was their an official document had a tremendous impact on the erudite skills in the art, philosophy and science of the general mood of Chinese medicine practice during the traditional thought process that allowed them to break new 1930s and 1940s. ground by, for instance, categorising Western drugs in Around the same time, the outlawed “communist ban- energetic terms, or by relating the Triple Warmer to certain dit” (gongfei) Mao Zedong promulgated thoughts that anatomical tissues described by Western medicine. Al- were very similar to those of his nationalist adversaries. In though it was their declared goal to incorporate some of the 1942 he instructed his guerilla government to uproot all useful mechanics (yong) of Western medicine into the shamanic beliefs and superstitions in the Yan’an area and traditional mother body (ti) of Chinese medicine, their establish model public health villages5. Around the same parameters remained clearly “traditional at the core” - as time, he wrote that “old doctors, circus entertainers, snake the programmatic title of Zhang Xichun’s collected writ- oil salesmen, and street hawkers are all of the same sort”6. ings announces, Chinese at Heart But Western Where Appro- This brief line would have a truly devastating impact twenty- priate: Essays Investigating An Integrated Form of Medicine five years later when Mao’s works became the one and only (Yixue Zhong Zhong Can Xi Lu, 1933). source for the country’s definition of political truth. It was This day in which curious Chinese physicians could quoted in millions of copies of red “Mao Bibles” (Mao Zhuxi explore the phenomenon of Western medicine from an yulu), serving as the Red Guard’s main license for the equal footing was soon eclipsed by a period characterised uncompromising persecution of the rich culture of tradi- by the hierarchical structure which still defines the relation- tional medicine and its unique modes of practice, educa- ship between modern medicine and any traditional system tion, and theoretical discourse. of life science today. During the first half of the 20th century, a variety of events politicised Chinese medicine as the In Servitude at Mao’s Court: Chinese Communism despicable symbol of everything old and backward. It and the Conception of TCM, 1953-1976 became a pawn that reformers from all political camps The years 1953-59 witnessed what appears like a remark- sought to abolish. When this endeavor failed due to vehe- able reversal of Mao’s earlier views on Chinese medicine. ment public protest, the new stewards of state settled for Having graduated from the task of creating national respect forcing the unruly gargoyle of Chinese medicine into a for the “communist bandit” who now donned the emper- controlled existence that was subject not only to a rigorous or’s robes, he began to gradually advance his private ambi- purge of diagnostic methods and therapeutic modalities, tion of asserting leadership over the legion of budding but - most damaging to its integrity as a system in its own communist countries around the world. This objective re- right - the creeping replacement of its essential standards quired the conception of a socialist model that distinguished with the “correct” parameters of modern science. itself from the Russian paradigm of Marxist-Leninism by The political voice of Sun Yat-sen, the leader of the incorporating the regional attributes of third world coun- Republican revolution that toppled the dynastic system in tries.
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