By Jack Raso
Posted: Wednesday, September 1, 1999
ARTICLES
Publication Date: September 1, 1999
The trend in American health care has been away from superstition (e.g., religious credulity, belief in magic, or faith in chance), mysticism, vitalism, trial and error,* and the physician's relying mainly on his or her own practical medical experience¬and toward the systematic use of the best pertinent scientific evidence. I suspect that if this trend ever characterizes traditional Chinese medicine (TCM), TCM will have become something neither manifestly traditional nor Chinese.
What TCM comprises is far from clear, but traditionally its central theoretical concept has long been that of chi¬a mysterious alleged vital force that underlies functioning of body, mind, and spirit. TCM's long-standing acceptance may be less reasonably ascribable to the intrinsic therapeutic utility of its methods and medicinals than to its variety; the placebo effect; undereducation; superstition; and a lack of biomedical practitioners, technicians, and instruments in the developing countries of the Far East and Southeast Asia.
The July 17, 1999, issue of The British Medical Journal (BMJ) included a survey of 2,938 randomized controlled trials of TCM conducted and published in China between the early 1980s and the end of 1996. A randomized controlled trial (RCT) is an experiment (a) involving at least one tentative treatment or tentative preventive and one control (e.g., a placebo) and (b) designed so that subjects are allocated randomly into such groups and so that, either throughout the trial or only initially, subjects, administrators, and clinical staffers do not know which subjects are in which group. In principle, RCTs are a rigorous means of testing hypo-theses. According to the three authors of the BMJ article (professors at Chinese University of Hong Kong, Beijing Medical University, and the University of Exeter's Department of Comple-mentary Medicine, respectively), roughly 7,500 RCTs were published in Chinese journals of TCM before 1997. Out of context, this finding might suggest that TCM is evolving into a part of scientific-evidencebased healthcare. The researchers state, however: "Although methodological quality has been improving over the years, many problems remain."
Tang and associates further said of the 2,938 randomized controlled trials of TCM that:
- inappropriate describing of randomization methods used had been prevalent;
- only 15 percent of the trials had been "blinded" (i.e., characterized by a procedure whose purpose is to prevent throughout the trial awareness by patients, administrators, and/or clinical staffers of which subjects are in the experimental-treatment group and which are in a control group);
- trials whose subjects numbered at least 300 had been few;
- in many trials the "control" had been another TCM treatment;
- "often" the TCM "control" had not undergone RCT evaluation;
- long-term health consequences had not been the focus of most trials;
- effectiveness had rarely been reported quantitatively;
- in more than 50 percent of the trials data on baseline characteristics or on side effects had not been reported;
- in most of the trials the researchers had claimed the experimental treatment was effective ("indicating that publication bias may be common"); and
- acupuncture may be no more effective in the treatment of stroke than the "control treatments."
The evidential footing for TCM is shaky indeed. "The quality of trials of traditional Chinese medicine must be improved urgently," state Tang and associates (emphasis added), who recommend funding "large and well designed" RCTs on long-term major outcomes. The researchers did not say in the article who should finance such studies.
Is there an urgent need for such trials? Is there even a need? In general, TCM theories, theoretical constructs, and claims are scientifically implausible. Grandiose testing of TCM methods would increase the popular acceptance of TCM¬even of cockamamie methods whose names include "chi," "Chinese," or "Qigong."
In my opinion, government-funded research of TCM should be limited to pharmacognosy.**
Jack Raso, M.S., R.D., is ACSH's Director of Publications.
* a mode of problem-solving characterized by using various methods until the problem is solved, or by using a method or various methods and trying to detect and eliminate method defects
** the pharmacology subfield whose focus is medically useful substances that occur naturally, primarily those synthesized by medicinal and other plants
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Some Alt-Med Methods at Least Nominally Related to TCM*
Business Qigong:** Use of Qigong to de-stress employees, improve their health, and increase their productivity.
Chi Healing (Fa Chi): Component of Chi Lel in which "teachers" (apparently "doctors") allegedly bring "healing energy from the universe" to individuals to facilitate healing.
Chi Kung Empowerment: A purported means of releasing "blocked energy" from the body.
Chi Lelª (Chi-Lel Qigong): Variation of Qigong and Qigong therapy pioneered by Pang Ming, M.D., practiced at the Wahzhan Zhineng Chigong Clinic and Training Center (a "medicineless hospital" in Qinhuagdao, China), and promoted by Luke Chan, author of 101 Lessons of Tao (Benefactor Press, 1995) and Secrets of the Tai Chi Circle: Journey to Enlightenment. Chi Lel has four components: (1) generation of a strong belief (shan shin)¬e.g., by listening to testimonials¬that chi ("life energy") can heal all ailments; (2) Chu Chong; (3) Chi Healing; and (4) Lan Gong ("practice"), which includes methods from Zhineng Chigong.
Chi Nei Tsang (CNT, healing light massage, Internal Organ Chi Massage, Organ Chi Transformation Massage, Taoist Chi Nei Tsang, Taoist healing light technique): Component of the Healing Tao. CNT is a system of "Chinese deep healing" that involves massaging points in the navel area, a purported "storehouse" for cosmic, earthly, prenatal, and universal forces. The method allegedly promotes rejuvenation in patients without causing burnout in practitioners. Its theory posits "healing light energy" and a bodily system of chi and "meridians."
Chi Nei Tsang II: Method taught by the Healing Tao Co., in Chiang Mai, Thailand. Its theory posits "good Chi" and at least ten kinds of bodily "wind" (flatus), including the "sick or evil wind."
Chinese aromatic Qigong: Mode of manual exercise that allegedly generates various "aromatic fragrances."
Chinese hand analysis: Form of palmistry based on the ancient Chinese theory of the Five Elements. It is an alleged means of obtaining information on health, sexuality, vocation, and spirituality.
Chinese physiognomy: "Diagnostic" method of Chinese medicine whose postulate is that areas of the face correspond to internal organs.
Chinese traditional food therapy (Chinese food therapy): Form of "food therapy" of ancient Chinese origin. According to its theory, food can fortify the vital force and one can nourish any unsound internal organ just by eating the corresponding organ of an animal.
Chi Weight Lifting: Component of Bone Marrow Nei Kung that purportedly can rejuvenate bone marrow by supplying the body with abundant "Ching Chi," an alleged combi-nation of sex hormones and "sexual energy." It involves genitally lifting weights at-tached to the penis and scrotum or to the vagina.
Chi yoga: Apparently, a method whose purported purpose is development of a balanced, healthy body, mind, and spirit.
Dayan Qigong (Wild Goose Breathing Exercise): Series of sixty-four movements that imitate the postures and movements of the wild goose ("dayan" in Chinese). Practicing Dayan Qigong allegedly helps to delay aging and prolong life.
Fountain of Youth Qigong (Fountain of Youth): Purported ancient secret to increasing "Original Qi Energy" ("Yuan Qi," "the Primordial Qi"). It allegedly restores youth.
Keep Your Wife Happy Qigong: Subject of the book of the same name (East & West Publications, Ltd.) by Linhai. Its postulate is that the kidneys are "sexual engines" that "power" lovemaking. It apparently involves "energy cultivation" and "spiritual intimacy."
Natural Chi-gongSM: An American-style, purportedly scientific form of Qigong that is an alleged "brain exercise." It involves using the Bio-Energizer (Chi-Gong Helper Machine) to intensify one's "chi energy." Truman Yeh invented the Bio-Energizer and introduced the method.
* excerpts from A Dictionary of Alternative-Medicine Methods ( http://www.acsh.org/dictionary/index.html)
** pronounced "chee gong" or "chee gung"
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Source Notes:
Priorities Volume 11 Number 3 1999
