Classical Chinese Medicine

herbs“Classical Chinese medicine” (傳統中醫) refers to the system of medicine indigenous to mainland China as it was practiced prior to Mao Zedong’s “Great Proletarian Cultural Revolution” in the 1960’s & 70’s.  It is to be clearly distinguished from so-called “Traditional Chinese medicine” (系統中醫) or “TCM”, which actually translates more accurately to “systematized Chinese medicine” and refers to the system of so-called “traditional” medicine developed subsequently by the communist government which was in reality an effort to “modernize” the classical medicine by subjecting it to various poorly executed attempts at scientific verification and conformation with the principles of conventional Western medicine.

The vast majority of Oriental medicine practitioners active today are graduates of modern TCM colleges, and the few remaining classically-trained practitioners tend to pass on their art one on one through the master-apprentice relationship over many years, not in three or four year University seminars.

In the process of creating modern TCM an attempt was made to correlate classical Chinese medical concepts like “patterns of disharmony” (證候), acupuncture meridians (經脈 / 經絡), qi (氣), jing (精), shen (神), yin & yang (陰陽), etc. to conventional Western notions of gross anatomy, physiology, and pathology.  In the course of this poorly advised project a great deal of classical knowledge was either obscured, garbled or outright discarded.  In addition some select treatment methodologies of the classical medicine were emphasized dramatically out of proportion with their historical roles (such as acupuncture) whereas others were either de-emphasized (such as pulse & tongue diagnosis) or outright discarded (such as qigong therapy).

TCM from its inception was a political creation.  A full academic discussion of this process is beyond the scope of this article, but those interested in a more scholarly treatment are heartily encouraged to peruse Professor Heiner Freuhauf’s outstanding essay here.

It is important to keep in mind that the initial plan, as espoused by representatives of both the Nationalist government of Sun Yatsen (himself a doctor of Western medicine) and subsequently by the Mao Zedong’s Communist government, was to abolish the classical medicine altogether.

However there were two main problems with a plan to completely eradicate the practice of classical Chinese medicine from the country.  First was the incredible support it received from the vast majority of the Chinese citizenry unwilling to abandon their traditional healthcare practices.  Second, attempting to implement a system of conventional Western medicine in a country so large, so heavily populated, so underdeveloped, and frankly so poor was quite simply far too expensive a proposition to undertake.  In the first half of the 20th century the “medicine question” in China remained unresolved.

Notwithstanding a few flip-flops on the issue by Chairman Mao, such as when he contrived the idea encourage traditional forms of healthcare amongst the general populace in order to lessen the country’s dependence on Western medical supplies and equipment from the Soviet Union, or the famous occasion when he became ill himself and called for two classically trained Chinese doctors, it was during his “Cultural Revolution” that the practice of classical Chinese medicine reached perhaps the lowest point in its two millennia history.

Chairman Mao wrote that classical Chinese doctors were nothing better than “circus entertainers, snake oil salesman or street hawkers”, and during the Cultural Revolution his “red guards” treated them as such.  Famous classically-trained doctors were imprisoned, tortured, exiled to forced labor camps, and otherwise persecuted in myriad ways along with other intellectuals, religious officials, and any other representatives of the old “feudal” order.  Following in the wake of the devastation of the Cultural Revolution a political decision was made to bring what remained of the classical medicine “up to snuff” by subjecting it to the rigor of scientific investigation and experiment not according to its own theoretical paradigm as outlined in the classical texts, but according to the principles and theories of conventional Western medicine.

The result was the highly modified and often internally inconsistent system upon which was bestowed the name “traditional Chinese medicine” or “TCM”, a system in which classical therapies are often prescribed not in response to classically-recognized patterns of disharmony, but in response to the diagnosis of conventional medical pathologies.  Much of the theoretical framework within which the classical medicine had been practiced for thousands of years was replaced with formulaic “cookbook” lists of prescriptions – for appendicitis take this herb, for high blood pressure stick needles here, etc.

Throughout the history of this regrettable process there have been voices of protest calling for a return to the theoretical foundations of the classical medicine, for a “renaissance” of the way classical medicine was practiced before it was forced to conform itself to a foreign theoretical paradigm.  However the support for a return to what we today like to call “classical Chinese medicine” did not really coalesce into a coherent movement until the late 1990’s/early 2000’s, a period roughly corresponding to the years Dr. Jiang Feng spent primarily in traveling outside of mainland China treating foreign patients.