Traditional Chinese Medicine

A modern version of acupuncture meridians and acupoints, from WHO, World Health, December 1979, p.10.

Traditional Chinese Medicine, as understood today, is a concept generated from political struggles and diplomatic concerns.

   From a broad ethnological perspective, traditional Chinese medicine is recognized as one of the oldest medical systems in the world. With origins spanning over 2,500 years, it encompasses a wide array of healing practices, including herbal medicine, acupuncture, moxibustion, massage, breathing exercises, and ritual-based techniques (Zhuyoushu). Rooted in ancient Chinese cosmology, the foundational principles of Chinese medicine were first articulated in the Inner Canon of the Yellow Emperor (Huangdi Neijing), a seminal text that reached its final form around the first few centuries CE. It emphasized achieving balance within the body and fostering harmony between humans and nature through concepts such as yin-yang, the Five Elements (wood, fire, earth, metal, and water), and the flow of qi (vital energy) through the body’s meridians. These principles laid the groundwork for understanding disease aetiology, developing diagnostic methods, and adopting therapeutic approaches. Through interpretation and elaboration of classical texts, Chinese medicine continuously developed, giving rise to various distinct schools until the 19th century.

   However, the term “traditional Chinese medicine (TCM)” as it is understood today is largely a politically infused concept, formulated in the 20th century, and particularly during Maoist China. In the early 20th century, traditional Chinese medicine faced growing challenges from biomedicine. Embracing Western modernity and aiming to reconstruct China, the Nationalist government of the Republic of China (1912–1949) sought to eradicate traditional medical practices entirely. This movement peaked in 1929 with the passage of the bill entitled Abolishing the Old Medicine in Order to Clear the Obstacle for Health and Medicine, which aimed to ban traditional Chinese medicine outright. 

   However, at the time, Western medicine accounted for only a small portion of the healthcare system, and a large majority of the population continued to rely on indigenous healers. Moreover, the proposed ban threatened the livelihoods of numerous pharmaceutical merchants, prompting widespread protests that ultimately rendered the bill ineffective. By the 1930s, nonetheless, Chinese medicine practitioners were still required to “scientize” their knowledge and practices, which often involved integrating traditional Chinese medicine with biomedical approaches. For instance, in acupuncture, Western anatomical and physiological theories were used to reinterpret acupuncture points, and healers were required to disinfect before needling.

   The People’s Republic of China, established in 1949, initially adopted a similar stance toward traditional medicine. While the new regime identified “uniting Chinese and Western doctors” as a key health policy as early as 1950, its practical implementation continued to prioritize the dominance of biomedicine. Traditional medicine practitioners were largely relegated to providing manpower for urgent grassroots health campaigns. To address these needs, the government organized numerous short-term training sessions for local practitioners, which focused exclusively on imparting knowledge of anatomy, physiology, disinfection techniques, and vaccination methods. At the time, the prevailing perspective viewed traditional medicine as a relic of feudal society, expected to diminish as the nation progressed socially and scientifically.

   Starting in the mid-1950s, China’s national policy on traditional medicine shifted abruptly under Chairman Mao’s direct intervention. Criticizing the Ministry of Health for its “bourgeois tendencies” that prioritized professionalism over socialist development, Mao redefined traditional medicine as part of China’s “national heritage” and a potential contribution to global medical progress. By forcing biomedically-trained doctors to study traditional medicine, the following policy encouraged reinterpretation of ancient medical knowledge through biomedical frameworks. In the meantime, institutions like the Shanghai College of TCM were established, and a series of standardized TCM textbooks were published by the late 1950s to support teaching and promotion efforts. By integrating with biomedicine and removing elements labelled as “superstition,” traditional medicine evolved into a more modern and scientifically aligned practice. This marked the beginning of what is now known as modern TCM. 

   The knowledge and practices of TCM gained further prominence during the Maoist period as an essential component of affordable healthcare for rural communities. Beginning in the late 1960s, TCM became part of rural health initiatives through the barefoot doctor program, which offered short-term training for farmers to deliver basic medical services in their villages. These practitioners integrated simple Western medicines with traditional herbal treatments and acupuncture, while also growing medicinal herbs to ensure availability and self-reliance.

   Since the 1970s, China’s TCM policy was internationally recognized as a major success. Landmark achievements included the development of acupuncture anesthesia for surgeries and the discovery of artemisinin, derived from a traditional herb, which revolutionized malaria treatment. During this period, heightened scepticism toward biomedicine, the rise of Third World countries, and the World Health Organization’s emphasis on primary healthcare further propelled the global spread of TCM. Beginning in the 1980s, however, China shifted toward an economy-driven approach, placing greater emphasis on the economic value of TCM. This shift prioritized the development of herbal-based pharmaceuticals and international trade, solidifying TCM’s role as both a cultural asset and a lucrative industry on the global stage.

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