The Historical Context of Traditional Chinese Medicine
In past decades, Traditional Chinese Medicine (TCM) has faced challenges in maintaining its market share and presence within the healthcare industry. Rooted in concepts like yin and yang, the five phases, and the harmony between heaven and humanity, TCM traces its origins back to 3,000 years ago during the Zhou dynasty. Influenced significantly by Confucian ethics emphasizing altruism, kindness, and adherence to rituals, TCM practitioners employ personalized observation techniques, including pulse diagnosis and tongue examination, inpatient treatment (Wang, 2019).
Despite China's considerable advancements in healthcare following the 2009 implementation of the "New Medical Reform," with a specific emphasis on expanding health insurance coverage and infrastructure, TCM has struggled, accounting for only 8% of total outpatient visits. Nevertheless, China's healthcare system has undergone expansions through various reforms, such as universal health insurance programs, zero-markup drug policies, patient referral systems, and medical alliances (Chen, 2019). By 2017, China had developed a robust healthcare infrastructure, boasting 8.91 million health technicians, including 3.35 million physicians and 3.79 million registered nurses, along with a network of over 30,000 hospitals and 94,000 township clinics (Zhou).
In contrast, TCM clinics face challenges with lower profit margins, with approximately 75% of TCM prices being lower than the actual costs. This pricing issue, combined with a shortage of licensed TCM professionals, particularly in rural areas, has resulted in a prevalent reliance on Western medicine. Rural China's healthcare scenario is further complicated by inadequate health facilities and personnel, revealing the intricacies within the public health services framework (Xu).
The decline of TCM can be traced back to historical events, notably the 1910 pneumonia epidemic in Manchuria, which solidified Western medicine's perceived superiority in treating patients. Western medicine not only contained the disease and prevented new cases but also allowed the imperial government to refrain from depending on Russian and Japanese military-led healthcare efforts. Although Western medicine was introduced to China by Western missionaries in the early 19th century, its widespread adoption occurred when the imperial government recognized its effectiveness in combating pneumonia in 1910 (Lei, 2014). Consequently, with the emergence of influential foreign powers like Japan, China assimilated Western medical practices to engage in modern medical discourse. Later, in 1949 under Mao Zedong's leadership, the official hybridization of Chinese and Western medicine took place. Early Western observers appreciated aspects of TCM while also acknowledging its foundations in mysticism and superstition. Intriguingly, as early as 1863, the French consul Dary de Thiersant pursued the study of TCM, publishing a book on medicine that integrated acupuncture techniques and philosophical principles from TCM (Contatore, 2018).
Works Cited
Contatore, O. A., Tesser, C. D., & Barros, N. F. (2018). Medicina Chinesa/acupuntura: Apontamentos históricos sobre a colonização de um saber. História, Ciências, Saúde-Manguinhos, 25(3), 841–858. https://doi.org/10.1590/s0104-59702018000400013
Lei, X. (2014). Neither donkey nor horse: Medicine in the struggle over China’s modernity. The University of Chicago Press.
Wang, Y. (2019). The scientific nature of traditional Chinese medicine in the post-modern era. Journal of Traditional Chinese Medical Sciences, 6(3), 195–200. https://doi.org/10.1016/j.jtcms.2019.09.003
Xu, Judy, & Yang, Y. (2009). Traditional Chinese medicine in the Chinese Health Care System. Health Policy, 90(2–3), 133–139. https://doi.org/10.1016/j.healthpol.2008.09.003
Zhou, M., Zhao, L., Kong, N., Campy, K. S., & Qu, S. (2018, July). What caused seriously shortage of Chinese nurses?. Iranian journal of public health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119566/
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