A mythology has grown up around traditional Chinese medicine (TCM). The ancient wisdom of the inscrutable Orient supposedly helped patients in ways that modern science-based medicine fails to understand or appreciate. A typical claim found on the Internet: “The ancient beliefs and practice of traditional Chinese medicine have been healing people for thousands of years.”
As Steven Novella has said, “TCM is a pre-scientific superstitious view of biology and illness, similar to the humoral theory of Galen, or the notions of any pre-scientific culture”. TCM really hasn’t been doing a creditable job of healing people for thousands of years. A book that was brought to my attention by one of our readers (thank you!) provides a unique insight into what Chinese medicine was really like circa 1900. I wish everyone who believes in ancient Chinese medical wisdom would read the chapter on Chinese medicine in this book. It provides a much-needed reality check.
Dugald Christie was a Scottish surgeon who served as a missionary doctor in northeastern China from 1883 to 1913. He wrote the book Thirty Years in Moukden. 1883-1913. Being the Experiences and Recollections of Dugald Christie, C. M.G. In providing medical care to Chinese patients, he initially met with strong resistance. People were suspicious of foreigners and spread vicious rumors about their evil doings. After he cured the blind with cataract surgery and helped patients the local doctors had failed to help, the community gradually realized he had something to offer that was far superior to what they were used to. Not just patients; people started flocking to his hospital to learn how to do what he did, and he eventually established the Mukden Medical College (still operating today under another name) to train Chinese doctors in Western medicine. During his 30 years in China he had ample opportunity to observe the practice of TCM.
The book is available online for free, but I’ll save you the trouble of reading it and describe the illuminating historical account of TCM in its pages. It serves as a reality check to those who believe in acupuncture, in “ancient wisdom,” and in the efficacy of non-Western medical practices.
Chinese doctors own that they know nothing at all of surgery. They cannot tie an artery, amputate a finger or perform the simplest operation. The only mode of treatment in vogue which might be called surgical is acupuncture, practised for all kinds of ailments. The needles are of nine forms, and are frequently used red-hot, and occasionally left in the body for days. Having no practical knowledge of anatomy, the practitioners often pass needles into large blood vessels and important organs, and immediate death has sometimes resulted. A little child was carried to the dispensary presenting a pitiable spectacle. The doctor had told the parents that there was an excess of fire in its body, to let out which he must use cold needles, so he had pierced the abdomen deeply in several places. The poor little sufferer died shortly afterwards. For cholera the needling is in the arms. For some children’s diseases, especially convulsions, the needles are inserted under the nails. For eye diseases they are often driven into the back between the shoulders to a depth of several inches. Patients have come to us with large surfaces on their backs sloughing by reason of excessive treatment of this kind with instruments none too clean.
A black resinous plaster is applied for pain, aching, bruising, swelling, wounds and sores.
A boy of nine was brought in a basket, and when the plaster completely covering one leg was removed, the smell could almost be heard, as the Chinese say. A large part of the tibia was quite bare and projecting. His mother said that no medicine had been applied except this plaster, which had first been used about fifteen months before, when there was only a small sore place, caused by a fall. He was now much emaciated, with weak rapid pulse and bad cough, and death seemed not far off. We took him into the hospital, treated the leg rationally, and after a few days removed the diseased bone entirely. In a month he was walking about, rosy, strong, and merry, and with great enthusiasm learning to read and sing hymns. Such cases are very common in every hospital.
A little boy twisted his leg while playing. A well-known Chinese doctor violently pulled and twisted his leg. Before the treatment he could walk; after it he couldn’t even stand. The Chinese doctor had dislocated his hip, and when Dr. Christie saw him 3 weeks later he was in so much pain that he had to be given chloroform just so he could be examined. Christie then replaced the hip in its socket, and the patient recovered promptly.
Mercury for bullet wounds
He describes removing a piece of bone from a severe gunshot wound, upon which a quantity of pure mercury poured out. The patient said, “That is the melted bullet!” Chinese doctors make no attempt to extract bullets, and they put mercury into the wound saying it will “melt the lead.” The patient is easily deceived.
The skin is pinched up and twisted repeatedly and sharply between the fingers or knuckles, or with two bits of wood or copper coins, until it becomes livid. Cupping is also a common method. People are constantly seen with round livid patches on the forehead. “What is wrong?” one asks at first in alarm. But the inevitable surprised answer is: “I had a headache, that is all.” Blisters of many kinds are also freely used, and the actual cautery.
They had only recently started using vaccination for smallpox. In the past, they “vaccinated” by blowing lymph up the nostril.
Lucky days are chosen for taking medicines. A hair is twined around a limb above a sore to keep the poison from going to the heart. A patient attributed his illness to punishment for having offended the Tiger-god by eating tiger’s flesh. A Chinese doctor brought his daughter to the Western doctor, asking him to operate to “remove the evil thing that is preying on her life.” He believed a tortoise was growing in her abdomen and drinking her blood three times a day. He thought he could feel the tortoise’s head moving; he was actually feeling the pulsations of her aorta. The child didn’t have an abdominal problem; she had advanced tuberculosis of the lungs.
Madness, epilepsy and hysteria are regarded as possession by devils. To drive the devils out, patients are forced to stand barefoot on red-hot iron and endure beatings. A girl of 17 with a bad case of hysteria died after a red-hot poker was thrust down her throat to expel the demon.
Patients have little confidence in their doctors. If the medicine doesn’t cure them in a few days, they set it aside and consult another doctor without telling the first. It is common to use the medicines of several doctors at once.
Note: This is important to know, because people commonly assume that an herbal treatment that has been used for centuries must be safe and effective because if it wasn’t the herbalists would have known by now and would have stopped using it. Patients switched doctors when the treatment wasn’t working, without telling the first doctor. So he would assume his treatment had cured the patient and he got no feedback about treatment failures and side effects. These ancient herbalists had no systematic way of evaluating treatment successes vs. failures or of discovering adverse effects.
A plague epidemic
In the winter of 1910-11, an epidemic of what was probably pneumonic plague swept through Manchuria. There were 43,942 cases recorded and 43,942 deaths. I was skeptical of those numbers, but they are also reported elsewhere by historians. 100% mortality; and we think Ebola’s bad! That’s a good demonstration of how effective TCM was. I would have expected at least a small percentage of patients to have survived without treatment, so this suggests that TCM may have been actively killing some patients.
The book offers a glimpse into history showing how truly ineffective and barbaric TCM really was. This information could go a long way to correct the misconceptions of those who have succumbed to the “ancient wisdom” fallacy. If they read it and paid attention. Which they won’t.
Plants often contain chemical compounds that act on the human body, and TCM accidentally came across some herbal remedies that actually work, but scientific testing is required to figure out which ones those are. And regulation of sources is required to prevent contaminants and ensure purification and standardization. TCM may have made a few serendipitous herbal discoveries, but as a system of medical care it has no validity. It is a historical curiosity and an anachronism.
This article was originally published in the Science-Based Medicine Blog.